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Associations Between Static and Functional Measures of Joint Function in the Foot and Ankle

James S. Wrobel, DPM, MS ^*, John E. Connolly, DPM ^* and Michael L. Beach, MD, PhD 

^* Surgical Service, Veterans Affairs Medical and Regional Office Center, White River Junction, VT.
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Corresponding author: James S. Wrobel, DPM, MS, Veterans Affairs Medical and Regional Office Center, Surgical Service #112E, White River Junction, VT 05009.

Abstract

Clinicians have traditionally assessed range of motion of the first metatarsophalangeal and ankle joints in a static position. It is unclear, however, if these measurements accurately reflect functional sagittal plane limitations of these joints during gait. For 50 patients (100 feet), we assessed available dorsiflexion at the first metatarsophalangeal and ankle joints, as well as the presence of pinch callus. We then compared these findings with 11 functional gait parameters, as measured using a pressure sensor system. After adjusting for age, weight, smoking status, glycosylated hemoglobin, and insensitivity to monofilament, we found that patients with pinch callus demonstrated statistically significant compensatory gait patterns in 7 of 11 measures. Hallux limitus and equinus patients demonstrated six and three statistically significant associations, respectively. Pinch callus seems to be as predictive of functional gait alterations as static first metatarsophalangeal joint and ankle dorsiflexion. (J Am Podiatr Med Assoc 94(6): 535–541, 2004)

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