title: Quantitative gait characteristics of children who had successful unilateral clubfoot operation.
abstract: OBJECTIVE
  In this study, we aimed to evaluate the functional results of patients operated for unilateral clubfoot who had good clinical outcome with gait analysis. We also investigated the deviation 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 surgically 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 recorded. All time-distance (walking velocity, cadence, step time, step length, double support time), kinematic (joint rotation angles of pelvis, hip, knee, and ankle in sagittal, coronal and transverse planes), and kinetic (ground reaction forces, moments, and powers of hip, knee, and ankle) 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 clubfoot 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 unilateral 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 reaction forces as well as decreased ankle and hip motion in sagittal plane.
  
  
  CONCLUSIONS
  Even asymptomatic well-treated children with unilateral clubfoot may have gait deviations 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 compensatory mechanisms.
authors.affiliation: Ankara Numune Training and Research Hospital, Orthopedics and Traumatology Clinic, Ankara, Turkey. ertugrul_aksahin@hotmail.com
authors.forename: Ertuğrul
authors.initials: E
authors.lastname: Akşahin
authors.forename: H Yalçın
authors.initials: HY
authors.lastname: Yüksel
authors.forename: Güneş
authors.initials: G
authors.lastname: Yavuzer
authors.forename: Hasan Hilmi
authors.initials: HH
authors.lastname: Muratlı
authors.forename: Levent
authors.initials: L
authors.lastname: Celebi
authors.forename: Ali
authors.initials: A
authors.lastname: Biçimlioğlu
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003025:Clubfoot / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome