Journal of Orthopaedic Surgery (Jan 2017)
The foot abduction characteristics following Steenbeek foot abduction brace
Abstract
Purpose: We prospectively investigated the foot abduction characteristics following Steenbeek foot abduction brace (SFAB) use in corrected clubfeet. The foot abduction achievable in SFAB with knee flexion and extension was calculated to find the effectiveness and stretch exerted by it. Methods: Only children with corrected idiopathic clubfeet using SFAB for greater than 3 months were enrolled. The foot abduction with and without brace in knee extended and flexed positions was measured. Hip range of motion (ROM) with and without brace was also recorded. Results: The average age of 42 children ( 62 feet) was 24.25 months (range: 5–48 months). There was difference in foot abduction of 22.2° in knee extension and flexion with SFAB on. A significant change in foot stretch of 25.5° observed when the knee was moved from extended to flexed position indicated SFAB dynamicity. The SFAB was found to be an effective orthosis as it brought the corrected clubfoot into maximum abduction permissible in the foot during the phase of knee flexion. The tibial rotation accounted for a major component (61%) of apparent foot abduction with the brace on. A hip ROM of 52.2° was required for SFAB function. Conclusion: SFAB is a dynamic brace that functions better in flexed knee position. It is able to induce a near equivalent actual abduction available in the foot in flexed position of knee. There is a significant component of tibial external rotation in SFAB-induced foot abduction. SFAB function is also dependent on hip mechanics.