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Factors Affecting Subjective Symptoms in Children with Pes Planovalgus Deformity: A Study Using the Oxford Ankle Foot Questionnaire.
The Journal of Bone & Joint Surgery ( IF 4.4 ) Pub Date : 2020-09-02 , DOI: 10.2106/jbjs.19.01504
Jae Jung Min 1 , Soon-Sun Kwon 2 , Ki Hyuk Sung 1 , Kyoung Min Lee 1 , Chin Youb Chung 1 , Moon Seok Park 1
Affiliation  

Background: 

Idiopathic pes planovalgus is one of the most common foot deformities in children and adolescents. However, there is a discrepancy between subjective symptoms and radiographic severity in idiopathic planovalgus deformity, and very few studies have investigated this aspect. Further, the assessment of subjective symptoms in patients with pes planovalgus requires a quantitative scoring system for making meaningful comparisons, such as the Oxford Ankle Foot Questionnaire for Children (OxAFQ-c) and that for parents (OxAFQ-p). Therefore, the purpose of this study was to evaluate the factors affecting the symptoms of idiopathic planovalgus using the OxAFQ.

Methods: 

All patients who were ≤18 years of age, had visited our clinic for the evaluation of pes planovalgus deformity, and had completed the OxAFQ were included in this study. The anteroposterior talo-first metatarsal, lateral talo-first metatarsal, and hallux valgus angles were measured on weight-bearing radiographs. The data were analyzed using a multiple regression model, with age, sex, and radiographic indices as explanatory variables.

Results: 

Overall, 123 patients were enrolled in this study, and 246 standing foot radiographs were evaluated along with scores in each domain of the OxAFQ. The factors affecting physical domain scores in the OxAFQ-c were female sex (p = 0.047) and the anteroposterior talo-first metatarsal angle (p = 0.033). Age of ≥10 years was a significant factor (p < 0.05) affecting all domains in both the OxAFQ-c and OxAFQ-p other than the physical domain score.

Conclusions: 

Although pes planovalgus deformity is 3-dimensional, the forefoot abduction component of the deformity should be carefully assessed as it is closely related to subjective symptoms. Further, in female patients with a more severe anteroposterior talo-first metatarsal angle, an aggravation of symptoms with aging should be expected when managing pes planovalgus deformity.

Level of Evidence: 

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.



中文翻译:

影响平足畸形患儿主观症状的因素:一项使用牛津脚踝问卷调查的研究。

背景: 

特发性平膜葡萄球菌是儿童和青少年中最常见的足部畸形之一。然而,特发性平卵巢畸形的主观症状和影像学严重程度之间存在差异,并且很少有研究对此方面进行研究。此外,评估平胸患者的主观症状需要定量评分系统来进行有意义的比较,例如儿童牛津踝足问卷(OxAFQ-c)和父母(OxAFQ-p)。因此,本研究的目的是使用OxAFQ评估影响特发性扁平卵巢症状的因素。

方法: 

≤18岁,曾就诊过扁平疱疹畸形评估并完成OxAFQ的所有患者均纳入本研究。在承重X光片上测量前后距骨第一first骨,外侧距骨第一meta骨和拇外翻角度。使用多元回归模型分析数据,以年龄,性别和射线照相指数作为解释变量。

结果: 

总体而言,该研究共招募了123名患者,并评估了246足站立X线照片以及OxAFQ每个领域的得分。影响OxAFQ-c物理领域评分的因素是女性(p = 0.047)和前后距骨第一first骨角(p = 0.033)。年龄≥10岁是影响OxAFQ-c和OxAFQ-p中除物理域得分以外的所有域的重要因素(p <0.05)。

结论: 

尽管pes ovovalgus畸形是3维的,但应仔细评估畸形的前脚外展成分,因为它与主观症状密切相关。此外,在患有较严重的前后距骨第一first骨角的女性患者中,在处理扁平卵巢畸形时应预期随着年龄的增长症状会加重。

证据级别: 

预后IV级。有关证据水平的完整说明,请参见《作者说明》。

更新日期:2020-09-02
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