Footprint analysis in flatfoot assessment

Abstract

BACKGROUND: A flatfoot is the most common condition in the practice of a pediatric orthopedist. A flatfoot is primarily diagnosed based on the assessment of the degree of the foot flattening. Along with clinical examination, footprint analysis is often used in practice due to the safety of this study and convenience and ease of implementation.

AIM: This study aimed to determine how much footprints can correlate with the clinical assessment of flatfoot in children and which footprint indices are the most valuable in flatfoot assessment.

MATERIALS AND METHODS: The study included the survey results of 76 children aged 7–15 years of the St. Petersburg 49th school “School of Health” for 2021–2022. In this study, anthropometric data, clinical parameters (value of the heel valgus, arch angle, and Friedland index) and footprint indices and angles (Schwartz and Clarke angle, Chippaux–Smirak index, Staheli index, Cavanagh and Rodgers index, and Irwin index) were analyzed. In the study, the average values were calculated, and correlation and regression analyses were performed.

RESULTS: The footprint parameters did not have moderate and strong correlations with clinical parameters. Footprint parameters that assessed the area of the barefoot zone on the footprints (Irwin index and Cavanagh and Rodgers index) showed statistically significant moderate and strong correlations among plantographic parameters. Among linear and angular footprint parameters, the Chippaux–Smirak index showed statistically significant moderate and strong correlations.

CONCLUSIONS: The footprint criteria weakly correlated with the foot shape criteria in a clinical assessment, which does not allow us to interpolate the footprint’s data to the clinical evaluation data of the foot. The Cavanagh and Rodgers index, Irwin index, and Chippaux–Smirak index had statistically significant moderate and strong correlations with other indices, which makes them more valuable in the assessment of feet according to the footprint analysis.

Keywords

flatfoot / flatfeet / footprints / footprint analysis / clinical and radiological parameters of the feet / flatfoot assessment

References

[1] Banwell HA, Paris ME, Mackintosh S, et al. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review. J Foot Ankle Res. 2018;1(11). DOI: 10.1186/s13047-018-0264-3

[2] Banwell H.A., Paris M.E., Mackintosh S., et al. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review // J. Foot Ankle Res. 2018. Vol. 1. No. 11. DOI: 10.1186/s13047-018-0264-3

[3] Banwell HA, Paris ME, Mackintosh S, et al. Paediatric flexible flat foot: how are we measuring it and are we getting it right? A systematic review. J Foot Ankle Res. 2018;1(11). DOI: 10.1186/s13047-018-0264-3

[4] Uden H, Scharfbillig R, Causby R. The typically developing paediatric foot: how flat should it be? A systematic review. J Foot Ankle Res. 2017;1(10). DOI: 10.1186/s13047-017-0218-1

[5] Uden H., Scharfbillig R., Causby R. The typically developing paediatric foot: how flat should it be? A systematic review // J. Foot Ankle Res. 2017. Vol. 1. No. 10. DOI: 10.1186/s13047-017-0218-1

[6] Uden H, Scharfbillig R, Causby R. The typically developing paediatric foot: how flat should it be? A systematic review. J Foot Ankle Res. 2017;1(10). DOI: 10.1186/s13047-017-0218-1

[7] Horii M, Akagi R, Ogawa Y. Foot morphology and correlation with lower extremity pain in Japanese children: a cross-sectional study of the foot posture Index-6. Orthop Sci. 2021;28(1):212–216. DOI: 10.1016/j.jos.2021.09.014

[8] Horii M., Akagi R., Ogawa Y. Foot morphology and correlation with lower extremity pain in Japanese children: a cross-sectional study of the foot posture Index-6 // J. Orthop. Sci. 2021. Vol. 28. No. 1. P. 212–216. DOI: 10.1016/j.jos.2021.09.014

[9] Horii M, Akagi R, Ogawa Y. Foot morphology and correlation with lower extremity pain in Japanese children: a cross-sectional study of the foot posture Index-6. Orthop Sci. 2021;28(1):212–216. DOI: 10.1016/j.jos.2021.09.014

[10] Pita-Fernández S, González-Martín C, Seoane-Pillado T, et al. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. J Epidemiol. 2015;2(25):148–154. DOI: 10.2188/jea.JE20140082

[11] Pita-Fernández S., González-Martín C., Seoane-Pillado T., et al. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older // J. Epidemiol. 2015. Vol. 2. No. 25. P. 148–154. DOI: 10.2188/jea.JE20140082

[12] Pita-Fernández S, González-Martín C, Seoane-Pillado T, et al. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. J Epidemiol. 2015;2(25):148–154. DOI: 10.2188/jea.JE20140082

[13] Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;4(25):253–263. DOI: 10.2519/jospt.1997.25.4.253

[14] Jonson S.R., Gross M.T. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen // J. Orthop. Sports Phys. Ther. 1997. Vol. 4. No. 25. P. 253–263. DOI: 10.2519/jospt.1997.25.4.253

[15] Jonson SR, Gross MT. Intraexaminer reliability, interexaminer reliability, and mean values for nine lower extremity skeletal measures in healthy naval midshipmen. J Orthop Sports Phys Ther. 1997;4(25):253–263. DOI: 10.2519/jospt.1997.25.4.253

[16] McPoil TG, Cornwall MW. Use of the longitudinal arch angle to predict dynamic foot posture in walking. J Am Podiatr Med Assoc. 2005;2(95):114–120. DOI: 10.7547/0950114

[17] McPoil T.G., Cornwall M.W. Use of the longitudinal arch angle to predict dynamic foot posture in walking // J. Am. Podiatr. Med. Assoc. 2005. Vol. 2. No. 95. P. 114–120. DOI: 10.7547/0950114

[18] McPoil TG, Cornwall MW. Use of the longitudinal arch angle to predict dynamic foot posture in walking. J Am Podiatr Med Assoc. 2005;2(95):114–120. DOI: 10.7547/0950114

[19] Inui K, Ikoma K, Imai K, et al. Examination of the correlation between foot morphology measurements using pedography and radiographic measurements. J Foot Ankle Surg. 2017;2(56):298–303. DOI: 10.1053/j.jfas.2016.10.020

[20] Inui K., Ikoma K., Imai K., et al. Examination of the correlation between foot morphology measurements using pedography and radiographic measurements // J. Foot Ankle Surg. 2017. Vol. 2. No. 56. P. 298–303. DOI: 10.1053/j.jfas.2016.10.020

[21] Inui K, Ikoma K, Imai K, et al. Examination of the correlation between foot morphology measurements using pedography and radiographic measurements. J Foot Ankle Surg. 2017;2(56):298–303. DOI: 10.1053/j.jfas.2016.10.020

[22] Onodera AN, Sacco IC, Morioka EH, et al. What is the best method for child longitudinal plantar arch assessment and when does arch maturation occur? Foot (Edinb). 2008;3(18):142–149. DOI: 10.1016/j.foot.2008.03.003

[23] Onodera A.N., Sacco I.C., Morioka E.H., et al. What is the best method for child longitudinal plantar arch assessment and when does arch maturation occur? // Foot (Edinb). 2008. Vol. 3. No. 18. P. 142–149. DOI: 10.1016/j.foot.2008.03.003

[24] Onodera AN, Sacco IC, Morioka EH, et al. What is the best method for child longitudinal plantar arch assessment and when does arch maturation occur? Foot (Edinb). 2008;3(18):142–149. DOI: 10.1016/j.foot.2008.03.003

[25] Vereschakina OA, Zaletina AV, Kenis VM. Effect of vitamin D on the health status in the perinatal period. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(4):60-65. (In Russ.). DOI: 10.17816/PTORS3460-65

[26] Верещакина О.А., Залетина А.В., Кенис В.М. Влияние уровня витамина D в перинатальном периоде на состояние здоровья // Ортопедия, травматология и восстановительная хирургия детского возраста. 2015. Т. 3. № 4. C. 60–65. DOI: 10.17816/PTORS3460-65

[27] Vereschakina OA, Zaletina AV, Kenis VM. Effect of vitamin D on the health status in the perinatal period. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2015;3(4):60-65. (In Russ.). DOI: 10.17816/PTORS3460-65

[28] Dimitrieva AYu, Kenis VM. Medium-term results of body balance trainings in primary school-aged children with generalized joint hypermobility and symptomatic flexible flatfoot: cohort study. Pediatricheskaya Farmakologiya. 2021;18(5):346–358. (In Russ.). DOI: 10.15690/pf.v1815.2326

[29] Димитриева А.Ю., Кенис В.М. Среднесрочные результаты тренировок баланса тела у детей младшего школьного возраста с генерализованной гипермобильностью суставов и симптоматическим мобильным плоскостопием: когортное исследование // Педиатрическая фармакология. 2021. Т. 18. № 5. C. 346–358. DOI: 10.15690/pf.v1815.2326

[30] Dimitrieva AYu, Kenis VM. Medium-term results of body balance trainings in primary school-aged children with generalized joint hypermobility and symptomatic flexible flatfoot: cohort study. Pediatricheskaya Farmakologiya. 2021;18(5):346–358. (In Russ.). DOI: 10.15690/pf.v1815.2326

[31] Domarev AO, Klochkova OA, Kenis VM. Vrozhdennaya gipoplaziya trekhglavoy myshtsy goleni kak prichiny rigidnoy ekvinusnoy deformatsii stopy u rebenka 1,5 let: klinicheskoe nablyudenie. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2022;12:45–46. (In Russ.).

[32] Домарев А.О., Клочкова О.А., Кенис В.М. Врожденная гипоплазия трехглавой мышцы голени как причина ригидной эквинусной деформации стопы у ребенка 1,5 лет: клиническое наблюдение // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2022. Т. 12. C. 45–46.

[33] Domarev AO, Klochkova OA, Kenis VM. Vrozhdennaya gipoplaziya trekhglavoy myshtsy goleni kak prichiny rigidnoy ekvinusnoy deformatsii stopy u rebenka 1,5 let: klinicheskoe nablyudenie. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2022;12:45–46. (In Russ.).

[34] Kenis VM, Dimitrieva AJ, Suponeva NA, et al. Oxford ankle foot questionnaire: Localization in Russia. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2021;9(2):135-142. (In Russ.). DOI: 10.17816/PTORS64382

[35] Кенис В.М., Димитриева А.Ю., Супонева Н.А., и др. Оксфордский опросник оценки состояния стопы у детей (Oxford Ankle Foot Questionnaire): лингвокультурная адаптация в России // Ортопедия, травматология и восстановительная хирургия детского возраста. 2021. Т. 9. № 2. C. 135–142. DOI: 10.17816/PTORS64382

[36] Kenis VM, Dimitrieva AJ, Suponeva NA, et al. Oxford ankle foot questionnaire: Localization in Russia. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2021;9(2):135-142. (In Russ.). DOI: 10.17816/PTORS64382

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Sapogovskiy A.V., Ovechkina A.V., Abramov I.A., Agranovich O. ., Shubina A.I., Budkevich T.G.