GAIT ANALYSIS AND MUSCLE STRENGTH IN CHILDREN WITH SURGICALLY TREATEDCLUBFEET

Twenty-three children who had unilateral surgery for idiopathic clubfe et underwent gait analysis and isokinetic muscle-strength testing at a n average of 10 years after surgical release. Ankle sagittal-plane kin ematics were disturbed in 20 clubfeet. Fifteen children had an interna l foot-progression angle. Genu valgum and knee hyperextension were com mon. Plantarflexion power was decreased by 23% on the side of surgery (p = 0.00005). Quadriceps weakness (defined as a decrease in strength >10% of the nonoperated-on limb's strength) was seen in nine of 22 ope rated-on limbs and ham-string weakness in eight of 22. Gastroesoleus w eakness exceeded 10% in 16 of 21 clubfeet, Average weakness of the gas troesoleus was 27% (p < 0.05), Ten-year analysis of children treated w ith clubfoot releases revealed disturbances in ankle motion and streng th. Loss of plantarflexion power and gastroesoleus strength can be pre dicted by Achilles tendon lengthening. Knee kinematic abnormalities an d weakness also were seen. These abnormalities produce functional diff iculties in gait and may lead to degenerative changes later.