| Popis: |
Clinical management of foot deformity has a strong evidence base in the literature. Nonetheless, new technologies can provide additional information for treatment planning and evaluation of treatment outcomes. Indeed, clinical gait analysis methods have evolved over the past 20 years and as clinicians translate new methods into clinical practice, they must determine whether the additional data supports, or opposes, current clinical management protocols. In the treatment of two common clinical deformities, equinus and equinovarus, a standard clinical management approach is relatively universal. Equinus contracture is treated with calf lengthening surgery, specifically to the Achilles tendon, which was popularised in the 1400s. Equinovarus, specifically in a clubfoot population, is most commonly treated with the Ponseti method, which has remained relatively unchanged since its development in the 1960s. In severe cases of clubfoot, tibialis anterior transfer surgeries for equinovarus follow the same protocols as described in 1940s. Whilst all of these interventions are thought to provide adequate results, new technologies present an opportunity to thoroughly evaluate their impact on gait outcomes. The aim of this thesis is to utilize new and emerging methods of gait analysis to assess current surgical interventions for common deformities of the foot and ankle. Methods of analysis presented and utilised in this thesis include: (i) musculoskeletal modelling for estimating muscle-tendon lengths, (ii) analysis of foot kinematics using a multi-segment foot model, and (iii) integrated multiple region kinematic-pressure analysis methods. |
