Long-term pathological gait pattern changes after talus fractures — dynamic measurements with a new insole
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The aim of the current study was to describe long-term gait changes after talus fractures, identify patterns associated with poor outcome and discuss possible treatment options based on dynamic gait analysis.
Twenty-seven patients were followed-up clinically and via gait analysis after talus fracture osteosynthesis. Continuous dynamic pedobarography with a gait analysis insole was performed on a standardized parcours consisting of different gait tasks and matched to the outcome.
Mean follow-up was 78.3 months (range 21–150), mean AOFAS and Olerud-Molander scores 66 (range 20–100) and 54 (range 15–100). Significant correlations between fracture classification and osteoarthritis (Hawkins: rs = 0.67 / Marti-Weber: rs = 0.5) as well as several gait differences between injured and healthy foot with correlations to outcome were seen: decreased step load-integral/maximum-load; associations between centre-of-pressure displacement and outcome as well as between temporospatial measures and outcome. Overall, pressure-distribution was lateralized in patients with subtalar joint injury (Δ: 0.5765 N/cm2, p = 0.0475).
Talus fractures lead to chronic gait changes and restricted function. Dynamic pedobarography can identify patterns associated with poor results. The observed gait patterns suggest that changes can be addressed by physical therapy and customized orthoses to improve overall outcome. The presented insole and measurement protocol are immediately feasible as a diagnostic and rehabilitation aid.
KeywordsTalus Fracture Gait analysis Pedobarography
We thank Sabine Drum, Martina Schweikert and Anh Tuan Vu for their excellent technical support and Ann Soether for her language editing.
Compliance with ethical standards
Conflict of interest
The insole material for this study was provided by the TK System of the AO Foundation. Senior Author Prof. Tim Pohlemann is Chairman of the TK System of the AO Foundation. Authors Tim Pohlemann and Benedikt Braun have served as unpaid advisors to Moticon GmbH. No further conflict of interest or funding sources exist.
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