Violation of supporting function of feet in children with hip subluxation of dysplastic genesis

Abstract

Objective. To study the plantographic characteristics of the feet in children with unilateral dysplastic hip subluxation (DHS) and to analyze the patterns of plantar pressure distribution on the affected and intact sides. Material and methods. A biomechanical study was conducted in 23 children, aged 13 to 17 years, with unilateral DHS of Crowe group I. The plantographic characteristics of the feet were evaluated and their relationship with the vertical balance of the patients body was analyzed. The control group consisted of 18 healthy children of the same age. Results. In patients with unilateral DHS, there is a significant decrease in all indices of support: anterior t, medial m and median s compared with healthy children, not only on the foot of the affected limb, but also on the intact side. It indicates a deterioration in the spring function of the transverse and longitudinal arches of the feet due to their rigidity. The foot on the affected lower limb has a pathologically increased Clarke's angle , which indicates an increase in the height of the longitudinal arches of the foot, which leads to a decrease in the total area of its support. In patients, there is a pathological increase in comparison with the norm of functional relationships between the arches of the foot on the affected and intact lower extremities, that is a sign of a formed pathological foot support strategy. Conclusions. The pathological supporting strategy of the feet on the affected and intact lower extremities in patients with unilateral DHS may be a consequence of a violation of the global sagittal balance of the body, leading to an adaptive reaction of the musculoskeletal system in response to compensatory changes in the links of the kinematic chain "spine-pelvis".