Comparative Analysis of Structural Differences in Progressive Collapsing Foot Deformity With and Without Hallux Valgus.

Foot & ankle international Pub Date : 2025-01-01 Epub Date: 2024-11-26 DOI:10.1177/10711007241298672
Chien-Shun Wang, Erik Jesús Huánuco Casas, Grayson M Talaski, Antoine S Acker, Mark E Easley, Cesar de Cesar Netto
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Abstract

Background: Progressive collapsing foot deformity (PCFD) and hallux valgus (HV) are complex 3-dimensional deformities of the foot. This study aimed to investigate structural and alignment differences between PCFD with and without HV using weightbearing computed tomography.

Methods: Patients with PCFD aged 18 years or older who underwent weightbearing computed tomography were consecutively enrolled. Standard 2-dimensional PCFD and HV parameters were assessed semiautomatically. Foot and ankle offset, forefoot arch angle, and pronation of the medial column bones in the coronal plane, with the ground as a reference, were manually measured. Additionally, the angles from the inferior aspect of subtalar posterior facet of the talus to the ground (subtalar horizontal angle), from the inferior (posterior facet) to superior facets of the talus (infratalar-supratalar angle), and from the inferior (posterior facet) of the talus to the superior facet of the calcaneus (infratalar-supracalcaneal angle) were examined. HV deformity was defined by an HV angle of ≥15 degrees.

Results: Among 72 feet (58 patients) studied, 33 displayed HV, whereas 39 did not. In the coronal plane, the PCFD with HV group showed a higher infratalar-supratalar angle and greater pronation at the first tarsometatarsal joint, first metatarsal bone, and head. The PCFD with HV group also exhibited greater naviculocuneiform joint supination. Generalized estimating equation logistic regression analysis revealed significant associations of HV deformity with the intrinsic rotation of the first metatarsal bone (P < .001), infratalar-supratalar angle (P = .004), and rotation of the first tarsometatarsal joint (P < .001).

Conclusion: This study confirmed significant structural and alignment differences between PCFD with and without HV. Notably, the infratalar-supratalar angle, rotation of the first tarsometatarsal joint, and intrinsic rotation of the first metatarsal bone were associated with HV deformity.

Level of evidence: Level III, retrospective comparative study.

伴有和不伴有拇指外翻的进行性塌足畸形的结构差异对比分析。
背景:进行性塌足畸形(PCFD)和足外翻(HV)是足部复杂的三维畸形。本研究旨在利用负重计算机断层扫描技术研究PCFD与HV之间的结构和排列差异:方法:连续招募 18 岁或以上接受负重计算机断层扫描的 PCFD 患者。半自动评估标准二维 PCFD 和 HV 参数。在冠状面上,以地面为参照物,手动测量足踝偏移、前足弓角和内侧柱骨的前倾。此外,还检查了距骨下端(后端面)到地面的角度(距骨下水平角)、距骨下端(后端面)到上端面的角度(距骨下水平角-距骨上水平角)以及距骨下端(后端面)到小方骨上端面的角度(距骨下水平角-小方骨上水平角)。HV角≥15度定义为HV畸形:在研究的 72 只脚(58 名患者)中,33 只显示 HV,39 只未显示 HV。在冠状面上,有 HV 的 PCFD 组显示跖下-跖上角更大,第一跖跗关节、第一跖骨和头部的前倾更大。PCFD 和 HV 组还表现出更大的舟状关节上翘。广义估计方程逻辑回归分析显示,HV畸形与第一跖骨的内在旋转(P P = .004)和第一跖跗关节的旋转(P 结论:HV畸形与第一跖骨的内在旋转和第一跖跗关节的旋转有显著的相关性:本研究证实,有 HV 和无 HV 的 PCFD 在结构和排列上存在明显差异。值得注意的是,跖下角-跖上角、第一跖跗关节的旋转和第一跖骨的内在旋转与 HV 畸形有关:证据级别:III级,回顾性比较研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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