Plantar pressure displacement after anesthetic motor block and tibialnerve neurotomy in spastic equinovarus foot

摘要

The aim of this study was to analyze the displacementsof center of pressure (COP) using an inshoe recordingsystem (FScan) before and after motor nerve block and neurotomyof the tibial nerve in spastic equinovarus foot. Thirtyninepatients (age 45 +/– 15 yr) underwent a motor nerve block; 16(age 38 +/– 15.2 yr) had tibial neurotomy, combined with tendinoussurgery (n = 9). The displacement of the COP (anteroposterior[AP], lateral deviation [LD], posterior margin [PM]) wascompared between paretic and nonparetic limbs before andafter block and surgery. At baseline, the nonparetic limb had ahigher AP (17.3 vs 12.3 cm, p < 0.001) and LD (4.0 vs 3.3 cm,p = 0.001) and a smaller PM (2.9 vs 4.7 cm, p = 0.001). For theparetic limb, a significant increase of AP was observed afterblock (13.5 vs 12.3 cm, p = 0.02) and after surgery (13.7 vs12.3 cm, p = 0.03). A significant decrease of PM was observedafter surgery (4.5 vs 3.3 cm, p < 0.001) with no more differencebetween two limbs (2.8 vs 3.3 cm, p = 0.44). This study showsthat the FScan system can be used to quantify impairments andbe useful to evaluate the effects of treatment for spastic foot. Itsuggests that changes in AP displacement following block maypredict the effects of neurotomy.