Significance of estimation criteria in pediatric flatfoot
Year: 2020, volume 16 Issue: №4 Pages: 905-911
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sertakova A.V., Rubashkin S.A., Timaev M.Kh., Dokhov M.M., Korshunova G.A., Zvereva K.P., Agafonova N.Yu.
Organization: Saratov State Medical University
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sertakova A.V., Rubashkin S.A., Timaev M.Kh., Dokhov M.M., Korshunova G.A., Zvereva K.P., Agafonova N.Yu.
Organization: Saratov State Medical University
Summary:
Objective: to analyze a set of versatile criteria for assessing flatfoot in children and identify the most significant for flatfoot diagnosis. Material and Methods. We conducted a cross sectional study that involved 150 patients with flatfoot diagnosis (mean age 9.5 ±0.8 у. o.) and 50 patients with neutral feet (mean age 10.1 ±1.3 у. o.). The examination of the children suggested a set of methods including the clinical one, quality-of-life questionnaire survey, X-ray and computed tomography, biomechanical and electroneuromyography (ENMG) methods. The findings of the conventional diagnostic tests underwent clustering and mathematical simulation. Results. The statistically significant X-ray indicators for flatfoot diagnosis are: astragalus horizontal angle (p<0.001), longitudinal arch angle (p=0.038), arch height (p=0.053). The valid biomechanical indicators are the foot transfer time (p=0.044) and the support time (p=0.042) as the temporal characteristics of the gait. Electroneuromyography detected significant changes in the M-response and F-waves as well as F/M ratio with the calf muscle. In most cases, high-amplitude M-responses (13.4±1.6 mV, 7.7±0.8 mV in health) and F-waves (1603±235.4 mV, 360±115 mV in health) were registered from the calf muscles, exceeding the data in healthy children 5 times. 8 statistically significant indicators of 18 X-ray and 13 biomechanical criteria were assigned; they provide 77.3% of the correct diagnosis when used for the mathematical model. Conclusion. We established the most sensitive and statistically significant criteria for the flatfoot diagnosis in children. They enable the assessment of the changes severity in flatfoot and designing the medical decision making support system for choosing the proper treatment method when these criteria are used for the data base and the artificial intelligence predicative model.
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