Quantitative gait characteristics of children who had successful unilateral clubfoot operation

Objectives: In this study, we aimed to evaluate the functional results of patients operated for uni¬lateral clubfoot who had good clinical outcome with gait analysis. We also investigated the de¬viation from the normal, and determined the compensation mechanisms by comparing this data with the unaffected feet and with the feet of healthy children. Methods: Sixteen children [10 boys, 6 girls; mean age, 6.8 years (range 4-9 years)] with surgi¬cally treated unilateral clubfoot and 24 age-matched healthy children were included in the study. Foot length, calf circumference, ankle range of motion, and radiographic measurements were re¬corded. All time-distance (walking velocity, cadence, step time, step length, double support ti¬me), kinematic (joint rotation angles of pelvis, hip, knee, and ankle in sagittal, coronal and trans¬verse planes), and kinetic (ground reaction forces, moments, and powers of hip, knee, and ank¬le) data were evaluated. Results: Calf circumference and ankle range of motion of involved extremity were significantly less than the unaffected side (p<0.05). Quantitative gait data revealed that children with clubfo¬ot had slower walking velocity (0.75±0.25 m/sec vs. 1.02±0.18 m/sec, p=0.01), shorter stride length (0.72±0.23 m vs. 0.91±0.05 m, p=0.01) than healthy children group. Affected foot of uni¬lateral clubfoot patients had more toe-in than healthy children (-14.24±21.78° vs. 18.54±7.90°, p=0.001). Unaffected side showed increased pelvic excursions and medio-lateral ground reacti¬on forces as well as decreased ankle and hip motion in sagittal plane. Conclusion: Even asymptomatic well-treated children with unilateral clubfoot may have gait de¬viations both in the affected and unaffected sides. These alterations may also be the result of the subclinical involvement of the so called healthy foot by disease (clubfoot) as well as the com¬pensatory mechanisms.