Dynamic pedobarograph in evaluation of varus and valgus foot deformities

Objective documentation of dynamic varus and valgus deformities of the hindfoot is still a clinical dilemma. In a review of spastic foot deformities, clinical, radiographic, and foot pressure data were collected in 108 children with cerebral palsy. According to the clinical assessment, five categories of foot deformities were defined: severe varus, varus, neutral, valgus, and severe valgus. A coronal index of the pedobarograph was determined by comparing the pressure/time integral under the medial column to that under the lateral column of the foot. Coronal index is highly correlated with clinical assessment and offers better information than radiographic measurements in differentiating the clinical categories. The authors recommend the pedobarograph as the primary evaluation tool to measure the severity of deformity for patients with varus and valgus foot dysfunction. The severity of the deformity can be monitored with a single measurement, which has the best correlation with the clinical assessment. The clinical assessment is still the primary tool to determine general patterns, but it is difficult to apply an objective measurement. Radiographic study is most useful for the preoperative assessment when surgery is indicated.