Modeling a clinical instrumental system for objective assessment of foot function in patients with post-traumatic deformity of the ankle and calcaneus

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Abstract

BACKGROUND: Gait alterations in patients after surgery on the ankle and foot are associated with biomechanically driven complications. The surgery outcomes depend on an accurate assessment of the anatomical and functional characteristics of the foot. Clinical gait analysis was performed using the computerized hardware-software system F-Scan Mobile.

AIM: This study aimed to evaluate biomechanical gait parameters in patients with deformities of the ankle and foot before and after surgery.

METHODS: A single-center, prospective, non-randomized, controlled, experimental, quantitative, cohort study was conducted at the Department of Traumatology and Orthopedics No. 4 of the Priorov National Medical Research Center of Traumatology and Orthopedics (Moscow) during 2022–2024. A total of 102 patients with ankle arthrosis and post-traumatic calcaneal deformity were treated, including 68 men and 34 women, a mean age of 39 ± 17.61 years. All patients also underwent biomechanical assessment of functional foot parameters.

RESULTS: Treatment outcomes in patients included in the study were assessed 12 and 24 months after surgery. The mean follow-up period was 22.3 ± 9.42 months. The mean visual analog scale score before surgery was 6.5 ± 3.63, and 1.6 ± 0.81 after surgery, indicating a significant reduction in pain (p < 0.05). The mean AOFAS hindfoot score increased from 38 ± 23.31 preoperatively to 88 ± 10.55 postoperatively, with a significant improvement in questionnaire scores (p < 0.05). Subjective evaluation of treatment outcomes: 56 patients (54.9%) rated the results as excellent, 30 (29.4%) as good, 14 (13.7%) as satisfactory, and 2 (1.9%) as unsatisfactory.

CONCLUSION: The clinical model for biomechanical gait assessment provides objective data on the structure of the gait cycle in unilateral foot lesions and allows evaluating the adequacy of adaptive motor skills in patients before and after surgery, as well as during long-term follow-up. Patients were satisfied with the treatment outcomes, confirmed both clinically and through biomechanical assessment.

About the authors

Аnatoliy K. Orletskiy

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: nova495@mail.ru
ORCID iD: 0009-0000-1461-4802

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Igor S. Kosov

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: kozeti@mail.ru
ORCID iD: 0009-0008-7053-7213
SPIN-code: 3260-8950

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

Konstantin V. Shkuro

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: shkuro_kostya@mail.ru
ORCID iD: 0009-0004-8259-7994
SPIN-code: 3442-1306
Russian Federation, Moscow

Dmitriy O. Timchenko

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: d.o.timchenko@mail.ru
ORCID iD: 0009-0009-6859-2528
SPIN-code: 6626-2823

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Dmitriy O. Vasilyev

Priorov National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: A-tendo@mail.ru
ORCID iD: 0000-0002-6573-3243
SPIN-code: 8980-0432

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Nicolay A. Gordeev

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: nova495@mail.ru
ORCID iD: 0009-0002-4251-8070
SPIN-code: 5687-9521
Russian Federation, Moscow

Vladislav A. Jarikov

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: vladislav.zharikov1996@yandex.ru
ORCID iD: 0009-0000-9310-1318
SPIN-code: 5347-6881
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. F-Scan registration module placed on the participant.

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3. Fig. 2. Sensor-based podometric insole with markings.

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4. Fig. 3. Graphical representation of the center of pressure trajectory during right and left gait cycles.

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5. Fig. 4. Digital indicators of the center of pressure distribution trajectory.

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6. Fig. 5. Pressure distribution curve during walking.

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7. Fig. 6. 3D representation of pressure distribution during walking: a, forefoot push-off; b, midfoot rollover; c, heel-off.

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8. Fig. 7. Artifacts of center of pressure trajectory registration: 1, trajectory variability; 2, return moments of heel push-off forces.

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9. Fig. 8. Example of experimental standardized footwear.

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10. Fig. 9. Center of pressure trajectories recorded with experimental standardized footwear.

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11. Fig. 10. Electronic patient record.

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12. Fig. 11. Testing of patient М.: a, patient setup; b, walking on a flat surface; c, treadmill walking.

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13. Fig. 12. Graphs of the center of pressure moment as a function of time during walking of patient M. on a flat surface.

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14. Fig. 13. Center of pressure trajectory during walking of patient M. on a flat surface.

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15. Fig. 14. Graphs of the center of pressure moment as a function of time during treadmill walking of patient M.

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16. Fig. 15. Center of pressure trajectory during treadmill walking of patient M.

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