Background

Orthoses can stabilize the foot and restore the medial longitudinal arch for symptomatic flexible flatfoot. However, the effectiveness of orthoses remains controversial. The purpose of this study was to evaluate effectiveness of a customized soft inflatable orthosis on the medial longitudinal arch of flexible flatfoot patients under load.

Methods

We obtained CT scans of the feet of 14 healthy volunteers and 14 patients with flexible flatfoot under non- and simulated weight-bearing conditions. Then CT scans under the same conditions were taken for patients with flexible flatfoot equipped with soft inflatable orthosis. Three-dimensional models of the medial longitudinal arch and hindfoot were constructed from CT images. The three-dimensional mobility of the medial longitudinal arch joints under load was compared between patients with flexible flatfoot equipped with soft inflatable orthosis or not.

Findings

From non- to simulated weight-bearing condition, the eversion and dorsiflexion of the talocalcaneal joint, the eversion of the talonavicular joint, the abduction and dorsiflexion of the cuneonavicular joint, and the dorsiflexion of the first tarsometatarsal joint were significantly larger in patients with flexible flatfoot than healthy volunteers. The customized soft inflatable orthosis could reduce the eversion of the talonavicular joint and the eversion and dorsiflexion of the talocalcaneal joint.

Interpretation

The soft inflatable orthosis is effective to improve medial longitudinal arch height and reduce excessive mobility of joints for flexible flatfoot deformity. The results of this study could provide evidence for the optimal orthosis design to treat flexible flatfoot in the future.

中文翻译：

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软充气矫形器对柔性扁平足畸形患者内侧纵弓的影响

背景

矫形器可以稳定足部并恢复有症状的灵活扁平足的内侧纵弓。然而，矫形器的有效性仍然存在争议。本研究的目的是评估定制的软充气矫形器在负载下的柔性扁平足患者的内侧纵弓上的有效性。

方法

我们在非负重和模拟负重条件下对 14 名健康志愿者和 14 名灵活扁平足患者的足部进行了 CT 扫描。然后对装有软充气矫形器的柔性扁平足患者在相同条件下进行CT扫描。内侧纵弓和后足的三维模型由 CT 图像构建。比较了柔性扁平足患者是否配备软充气矫形器后内侧纵弓关节在负荷下的三维活动度。

发现

从非负重状态到模拟负重状态，距骨关节外翻和背屈、距舟关节外翻、楔舟关节外展和背屈、第一跗跖关节背屈明显更大。比健康志愿者扁平足。定制的软充气矫形器可以减少距舟关节的外翻和距跟关节的外翻和背屈。

解释

软充气矫形器可有效提高内侧纵弓高度，减少关节过度活动，以适应灵活的扁平足畸形。这项研究的结果可以为未来治疗柔性扁平足的最佳矫形器设计提供证据。