Plantar Pressure Analysis After Percutaneous Repair of Displaced Intra-articular Calcaneal Fractures

Abstract

Background: Clinical results for the treatment of displaced intra-articular calcaneal fractures are mainly expressed using disease-specific outcome scores, physical examination and radiographs. We hypothesized that plantar pressure and foot position analysis is a valuable tool in assessing foot function in patients with a unilateral displaced intra-articular calcaneal fracture treated percutaneously. Materials and Methods: With a followup of at least one year, 21 patients with a unilateral displaced intra-articular calcaneal fracture treated percutaneously participated in the study. The pedobarographic measurements in the injured foot were compared with the contralateral control foot. Correlations between the ratios (injured/control) of plantar pressure and foot position variables and outcome scores, the physical exam items ratios, the fracture classification, and the radiological parameters were calculated. Results: Statistically significant differences between the injured and the control foot were found for the weight distribution ( p = 0.002), total contact time ( p < 0.001), and the maximum pressure under the first metatarsal ( p = 0.02) after a median followup of 18 months. Of all correlations calculated, only the heel time ratio correlated significantly with the heel width ratio ( p = 0.004). Conclusion: Significant differences in plantar pressure distribution between the injured and uninjured foot were found, indicating that plantar pressure analysis and foot position analysis is an objective test to assess deviations in foot function. Plantar pressure data revealed limited correlation with outcome scores. Therefore, plantar pressure analysis should not be used instead of but in addition to established outcome scores.