title: Gait Analysis and Functional Outcome After Calcaneal Fracture.
abstract: BACKGROUND
  Calcaneal fractures are associated with substantial morbidity and socioeconomic impact, frequently leading to limited functional outcome and high economic costs. The Oxford foot model (OFM) has been reported as a valid addition to the biomechanical examination of the foot. The aim of our study was to analyze the gait of patients after operative repair of a calcaneal fracture in relation to functional outcome and radiographic findings.
  
  
  METHODS
  Thirteen patients with a calcaneal fracture underwent gait analysis with OFM at a minimum of six months after open surgery. Intersegmental range of motion was measured during gait. Results were compared with those of healthy subjects and those of patients who had undergone subtalar arthrodesis. Patient-reported questionnaires and radiographic images were also evaluated.
  
  
  RESULTS
  The range of motion between the hindfoot and the tibia in the push-off phase in the transverse plane was significantly correlated with the clinical outcome as reported by patients based on the Foot and Ankle Disability Index (FADI) (r(2) = 0.51; p < 0.001) and the Short Form (SF)-36 physical component summary score (r(2) = 0.52; p < 0.001). We found a significant correlation between the step-off in the subtalar joint as measured on postoperative computed tomography (CT) and range of motion (r(2) = -0.74; p = 0.004). The step-off was also correlated with the patient-reported outcome questionnaire FADI (r(2) = -0.76; p = 0.003) and the SF-36 physical component summary score (r(2) = -0.78; p = 0.002).
  
  
  CONCLUSIONS
  This study demonstrated that the subtalar joint range of motion of patients after a calcaneal fracture was related both to the quality of the reduction of the subtalar joint as evaluated on postoperative CT scans and patient-reported functional outcome.
authors.affiliation: Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. E-mail address for S. van Hoeve: s.vanhoeve@student.maastrichtuniversity.nl.
authors.forename: Sander
authors.initials: S
authors.lastname: van Hoeve
authors.affiliation: Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. E-mail address for S. van Hoeve: s.vanhoeve@student.maastrichtuniversity.nl.
authors.forename: Jim
authors.initials: J
authors.lastname: de Vos
authors.affiliation: Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. E-mail address for S. van Hoeve: s.vanhoeve@student.maastrichtuniversity.nl.
authors.forename: Jan P A M
authors.initials: JP
authors.lastname: Verbruggen
authors.affiliation: Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 616, 6200 MD Maastricht, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Willems
authors.affiliation: Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 616, 6200 MD Maastricht, the Netherlands.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Meijer
authors.affiliation: Department of Surgery, Division of Trauma Surgery, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands. E-mail address for S. van Hoeve: s.vanhoeve@student.maastrichtuniversity.nl.
authors.forename: Martijn
authors.initials: M
authors.lastname: Poeze
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D005684:Gait; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013380:Subtalar Joint / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome