Riesgos ortopédicos en los niños andadores de puntillas de edad preescolar

Abstract

Introduction: Idiopathic tiptoe gait, considered as a diagnosis of exclusion of neurological and orthopedical diseases, has been related to various foot and ankle orthopedic alterations. The limitation of the ankle movement range is the main guideline for evaluation and therapeutical indication. However, its early assessment and its comparison with normality values have been seldom studied. The aim of the present work is to verify if the early evaluation of toe walkers (TW) reveals specific clinical characteristics denoting orthopedical risks. Patients and methods: A cross-sectional study was conducted to compare the posture and the movement of knee, ankle and foot of a group of 56 TW and a group of 40 controls (CG), aged 3 to 6 years old. Results: TW children, 69.6% of them boys (p= 0.008), did not suffer a knee flexum, but they demonstrated a lower passive ankle mobility measured with the knee flexed (p <0.05) and a diminution of the heel support while standing than CG children (p= 0.000). TW also showed more pronation of the foot, objectified in a higher calcaneus valgus, pronation angle, navicular drop and pronation peak observed in the footprint (p <0.05). Conclusions: Clinical evaluation in preschool ITW by means of specific measures helps detecting orthopedical risks. It could allow to set particular strategies to prevent their possible negative evolution.