Naoki Yoshioka1, Kazuya Ikoma2, Masamitsu Kido1, Kan Imai1, Masahiro Maki1, Yuji Arai1, Hiroyoshi Fujiwara1, Daisaku Tokunaga1, Nozomu Inoue3, Toshikazu Kubo1. 1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan. 2. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan. Electronic address: kazuya@koto.kpu-m.ac.jp. 3. Department of Orthopedic Surgery, Rush University Medical Center, United States.
Abstract
BACKGROUND: The recent classifications for posterior tibial tendon dysfunction (PTTD) stage II are based on forefoot deformity, but there is still no consensus regarding a detailed explanation of the clinical condition. The purposes of this study were to clarify the clinical condition of flatfoot deformity using three-dimensional (3D) computed tomography (CT) imaging under loading on both healthy and flat feet and to compare 3D movement of the forefoot in response to load. METHODS: Ten volunteers and 10 PTTD stage II patients with symptomatic flatfoot deformity were examined. CT scans of 20 healthy and 20 flat feet were performed under non-loading and full weight-bearing conditions. Images of the tibia and foot arch bones (talus, calcaneus, navicular, and first and fifth metatarsal bones) were reconstructed into 3D models. Rotations of individual tarsal bone or metatarsal bone were described by the Eulerian angles. RESULTS: Compared with healthy feet, flat feet experienced plantarflexion of the fifth metatarsal bone relative to the first metatarsal bone under loading conditions. We defined this phenomenon as synonymous with forefoot varus on the coronal plane. CONCLUSIONS: The results of this study have clarified part of the clinical condition of the forefoot in flatfoot deformity and may have applications in basic research of the staging advancement and substage classification of PTTD.
BACKGROUND: The recent classifications for posterior tibial tendon dysfunction (PTTD) stage II are based on forefoot deformity, but there is still no consensus regarding a detailed explanation of the clinical condition. The purposes of this study were to clarify the clinical condition of flatfoot deformity using three-dimensional (3D) computed tomography (CT) imaging under loading on both healthy and flat feet and to compare 3D movement of the forefoot in response to load. METHODS: Ten volunteers and 10 PTTD stage II patients with symptomatic flatfoot deformity were examined. CT scans of 20 healthy and 20 flat feet were performed under non-loading and full weight-bearing conditions. Images of the tibia and foot arch bones (talus, calcaneus, navicular, and first and fifth metatarsal bones) were reconstructed into 3D models. Rotations of individual tarsal bone or metatarsal bone were described by the Eulerian angles. RESULTS: Compared with healthy feet, flat feet experienced plantarflexion of the fifth metatarsal bone relative to the first metatarsal bone under loading conditions. We defined this phenomenon as synonymous with forefoot varus on the coronal plane. CONCLUSIONS: The results of this study have clarified part of the clinical condition of the forefoot in flatfoot deformity and may have applications in basic research of the staging advancement and substage classification of PTTD.
Authors: K P Iyengar; C A Azzopardi; J Fitzpatrick; T Hill; S Haleem; H Panchal; R Botchu Journal: Skeletal Radiol Date: 2022-02-10 Impact factor: 2.199
Authors: Eli Schmidt; Thiago Silva; Daniel Baumfeld; Kevin N Dibbern; Hee Young Lee; John Femino; Nacime Salomao Barbachan Mansur; Cesar de Cesar Netto Journal: Iowa Orthop J Date: 2021