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02.01.2018 | Original Paper

Long-term pathological gait pattern changes after talus fractures — dynamic measurements with a new insole

verfasst von: Benedikt J. Braun, Patrick Pelz, Nils T. Veith, Mika Rollmann, Moritz Klein, Steven C. Herath, Jörg H. Holstein, Tim Pohlemann

Erschienen in: International Orthopaedics | Ausgabe 5/2018

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Abstract

Purpose

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.

Methods

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.

Results

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: r_s = 0.67 / Marti-Weber: r_s = 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).

Conclusions

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.

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Titel: Long-term pathological gait pattern changes after talus fractures — dynamic measurements with a new insole
verfasst von: Benedikt J. Braun
Patrick Pelz
Nils T. Veith
Mika Rollmann
Moritz Klein
Steven C. Herath
Jörg H. Holstein
Tim Pohlemann
Publikationsdatum: 02.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 5/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3720-y

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