The Dynamicity of Steenbeek Foot Abduction Brace for Clubfoot in Dorsiflexion and Pronation

Purpose. Steenbeek foot abduction brace (SFAB) has been widely used in various national clubfoot programs. The aim of the study was to define effectiveness and dynamicity of SFAB in terms of dorsiflexion and pronation for the corrected clubfoot. Methods. Differences in foot dorsiflexion and pronation measurement with brace in knee flexed and extended position were recorded as dynamicity₁ and dynamicity₂, respectively. The residual soft tissue stretch lag despite brace use was calculated by determining the difference between maximum foot dorsiflexion (stretchlag₁) and pronation (stretchlag₂) achievable without and with brace in knee flexed. Statistical difference between measurements were calculated using paired t tests. Results. There were a total of 63 feet in 40 patients. The mean foot dorsiflexion with brace on in knee extension was 7.57° and in flexion was 15.20°. The foot pronation with brace on in knee extension was 9.46° and in flexion was 16.77°. Thus, SFAB exerted statistically significant differences in foot dorsiflexion and pronation between the knee extended and flexed positions. Dynamicity₁ and dynamicity₂ were 7.63° and 7.31°, respectively. Stretchlag₁ was 18.47° and stretchlag₂ was 17.63°. Conclusions. SFAB demonstrates effective dynamicity in maintaining corrected foot dorsiflexion and pronation. There is a residual soft tissue stretch lag both in dorsiflexion and pronation in corrected clubfoot despite use of SFAB.

Levels of Evidence: Therapeutic, Level IV: Case series