Article

Midfoot break (MFB) is a foot deformity that can occur when ankle dorsiflexion is
restricted due to muscle spasticity or contractures, causing abnormal increased
motion through the midfoot. MFB has been previously described in terms of
forefoot (FF) and hindfoot (HF) motion in the sagittal plane. The purpose of this
study was to further classify MFB by describing FF and HF motion in the coronal
and transverse planes along with plantar pressures, with the goal of optimizing
treatment of this deformity. Three-dimensional foot kinematics were assessed
using a multi-segment foot model in children with MFB (n=30) and children with no
foot or gait abnormalities (n=30). The MFB group was subdivided into three
categories: (1) Pronated MFB, (2) Supinated MFB and (3) Flat Foot MFB. Unique
patterns of plantar pressures and foot kinematics were identified for each MFB
group. The Pronated MFB group had increased medial midfoot pressures, increased
forefoot pronation, and increased external forefoot rotation (forefoot abductus).
The Supinated MFB group had increased lateral midfoot pressures, increased
forefoot supination, and increased internal forefoot rotation (forefoot
adductus). In the Flat Foot MFB group, midfoot pressures were increased and
distributed uniformly between the medial and lateral sides, forefoot pronation
was increased, and internal forefoot rotation was present. By combining this new
information with previously reported methods of measuring sagittal plane
kinematics of MFB, it is now possible to characterize midfoot break in terms of
severity and foot-floor contact pattern.
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