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Medial Longitudinal Arch Angle Presents Significant Differences Between Foot Types: A Biplane Fluoroscopy Study.

Megan E R Balsdon, Kristen M Bushey, Colin E Dombroski

    Journal of Biomechanical Engineering
    |August 23, 2016
    PubMed
    Summary

    This study measured the medial longitudinal arch (MLA) angle in different foot types using biplane fluoroscopy. Significant differences were found between normal, high arch (pes cavus), and low arch (pes planus) foot types during walking.

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    Area of Science:

    • Biomechanics
    • Orthopedics
    • Radiological Imaging

    Background:

    • The medial longitudinal arch (MLA) is crucial for foot function and plantar pressure dissipation.
    • Previous MLA assessments used static radiography or marker-based motion analysis.
    • A need exists for precise, dynamic MLA measurement across different foot types.

    Purpose of the Study:

    • To measure the contained medial longitudinal arch (MLA) angle using biplane fluoroscopy.
    • To compare MLA angles between pes planus (low arch), normal, and pes cavus (high arch) foot types.
    • To differentiate static versus dynamic MLA measurements during gait.

    Main Methods:

    • Utilized markerless fluoroscopic radiostereometric analysis (fRSA) with 3D foot bone models.
    • Matched 3D models to 2D biplane radiographic images during midstance of gait.
    • Recruited 15 participants (5 per foot type: pes planus, normal, pes cavus).

    Main Results:

    • Statistically significant differences in barefoot MLA angles were found between normal and pes cavus (p=0.036), and between pes cavus and pes planus (p=0.004) foot types.
    • Dynamic walking measurements showed significant differences compared to static standing (p=0.014).
    • The novel fRSA method successfully differentiated static and dynamic MLA kinematics.

    Conclusions:

    • Biplane fluoroscopy with fRSA provides a novel and accurate method for measuring contained MLA angles.
    • Significant differences in MLA angles exist between various foot types and during dynamic vs. static conditions.
    • Findings support clinical classification of foot types (pes cavus, pes planus) based on physical assessment.