Subtalar joint dynamics in progressive collapsing foot deformity: A cross-sectional progression model.

IF 2.4 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2026-09-10 DOI:10.1016/j.fas.2026.09.007

Pierre-Henri Vermorel, Francois Lintz, Enrico Pozzessere, Emily Luo, Mark Easley, Wolfram Grün, Cesar de Cesar Netto

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引用次数: 0

Abstract

Background: Peritalar subluxation (PTS) contributes to progressive collapsing foot deformity (PCFD), yet its pathophysiology remains unclear. This study analyzed subtalar joint (SJ) dynamics throughout deformity progression.

Methods: A retrospective review of 153 WBCT scans classified PCFD into four stages: (1) no PTS, (2) PTS without impingement, (3) PTS with sinus tarsi impingement (STI), and (4) PTS with subfibular impingement (SFI). Three-dimensional measurements of middle facet subluxation and incongruence, foot-ankle offset, SJ offset, and lateral process offset were compared between groups.

Results: Progression to PTS was characterized by internal talar rotation relative to the foot tripod. Progression to STI demonstrated medial talar translation and subtalar valgus opening. After STI onset, deformity progressed, with a shift in the center of rotation from the middle facet to the lateral talar process.

Conclusion: Internal talar rotation initiates PTS, while STI marks a turning point where collapse shifts toward the lateral talar process.

Level of evidence: Level 3 retrospective comparative study.

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进行性塌陷足畸形的距下关节动力学：一个横断面进展模型。

背景：椎体周围半脱位（PTS）导致进行性塌陷足畸形（PCFD），但其病理生理机制尚不清楚。本研究分析了距下关节（SJ）在畸形发展过程中的动力学。方法：回顾性分析153个WBCT扫描结果，将PCFD分为四个阶段：(1)无PTS，(2)无撞击，(3)有跗骨窦撞击（STI）的PTS，(4)有腓骨下撞击（SFI）的PTS。中间关节突半脱位和不一致、足-踝偏移、SJ偏移和外侧突偏移的三维测量在两组之间进行比较。结果：进展到PTS的特征是距骨内旋转相对于足三脚架。STI的进展表现为距内侧平移和距下外翻开口。STI发病后，畸形进展，旋转中心从中关节突转移到距侧突。结论：距内旋转引发PTS，而STI标志着塌陷向距外突转移的转折点。证据等级：3级回顾性比较研究。

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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.