Which factors are associated with failure of conservative treatment in progressive collapsing foot deformity?

IF 2.4 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2026-09-08 DOI:10.1016/j.fas.2026.09.002

Lolita Micicoi, Wolfram Grün, Emily Luo, Anna Bryniarski, Enrico Pozzessere, Viren Umrethiya, Pierre-Henri Vermorel, François Lintz, Cesar de Cesar Netto

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引用次数: 0

Abstract

Background: Progressive collapsing foot deformity (PCFD) has a variable course, with over 10% of patients progressing to surgery despite nonoperative treatment.

Methods: Adults with PCFD initially treated nonoperatively and baseline weight-bearing CT were retrospectively stratified into nonoperative and surgical groups. Demographics, PROMIS, and WBCT alignment were compared.

Results: Seventy-six feet were analyzed. Progression to surgery was associated with greater baseline hindfoot malalignment (Foot-Ankle Offset 9.0 ± 3.1 vs 6.6 ± 3.0, p = 0.046; Hindfoot Moment Arm p = 0.008), male sex (p = 0.008), and higher BMI (32.1 ± 7.3 vs 26.8 ± 5.2, p = 0.044). PROMIS and forefoot alignment did not discriminate outcomes.

Conclusion: In this exploratory cohort, a more valgus hindfoot alignment, male sex, and higher BMI emerged as potential predictors of failure of nonoperative treatment in PCFD, whereas baseline pain and physical function did not discriminate outcomes. These candidate factors warrant confirmation in larger, adequately powered studies before WBCT-derived alignment parameters can be used for risk stratification.

Level of evidence: Level III - Retrospective comparative study.

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哪些因素与进行性塌陷足畸形保守治疗失败有关？

背景：进行性塌陷足畸形（PCFD）有不同的病程，尽管非手术治疗，仍有超过10%的患者进展到手术。方法：采用非手术治疗和基线负重CT对成年PCFD患者进行回顾性分层，分为非手术组和手术组。比较了人口统计学、PROMIS和WBCT对齐情况。结果：分析了76英尺。发展为手术会导致更多的基线hindfoot错乱排列(脚踝抵消9.0 ±3.1 vs 6.6  ± 3.0,p = 0.046;hindfoot力臂p = 0.008),男性(p = 0.008),和较高的体重指数(32.1 ±7.3 vs 26.8  ± 5.2,p = 0.044)。前脚对齐和前脚对齐对结果没有差别。结论：在这个探索性队列中，更多的后足外翻、男性和较高的BMI是PCFD非手术治疗失败的潜在预测因素，而基线疼痛和身体功能并不能区分结果。在wbct衍生的对齐参数可用于风险分层之前，这些候选因素需要在更大、更有力的研究中得到证实。证据等级：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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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.