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Deformities Influencing Different Classes in Progressive Collapsing Foot.

Aly Fayed1, Vineel Mallavarapu1, Eli Schmidt1

  • 1Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

The Iowa Orthopaedic Journal
|January 12, 2024
PubMed
Summary
This summary is machine-generated.

Progressive collapsing foot deformity (PCFD) components are interconnected, except for ankle valgus. This suggests PCFD is a complex, three-dimensional condition where different foot and ankle regions influence each other.

Keywords:
AAFDPCFDWBCTflatfoothindfoot moment armmeary's anglemiddle facet subluxationmiddle facet uncoverageperitalar subluxationtalar tilt angletalonavicular coverage angleweight bearing CT

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Area of Science:

  • Orthopedics
  • Radiology
  • Biomechanical Engineering

Background:

  • Progressive collapsing foot deformity (PCFD) is a complex, three-dimensional condition affecting multiple foot and ankle regions.
  • The interrelationship between the 5 established classes of PCFD remains unclear.
  • This study investigates the influence of each PCFD class on others using angular measurements.

Purpose of the Study:

  • To assess the influence of each progressive collapsing foot deformity (PCFD) class on other classes.
  • To evaluate the correlation between angular measurements associated with different PCFD classes.
  • To determine if PCFD components are interdependent.

Main Methods:

  • Retrospective analysis of weight-bearing CT (WBCT) scans from 32 patients diagnosed with PCFD.
  • Defined and measured 5 classes of PCFD: Class A (hindfoot valgus, HMA), Class B (midfoot abduction, TNCA), Class C (medial column instability, Meary's angle), Class D (peritalar subluxation, MFU), and Class E (ankle valgus, TTA).
  • Multivariate analyses were performed to compare measurements between classes, with significance set at p < 0.05.

Main Results:

  • Class A (hindfoot valgus) strongly correlated with Class C (medial column instability) (ρ=0.71).
  • Class B (midfoot abduction) and Class D (peritalar subluxation) showed substantial positive correlations (ρ=0.74).
  • Class C correlated with Classes A and D, while Class D correlated with Classes B and C. Class E (ankle valgus) showed no significant correlation with Classes B, C, or D.

Conclusions:

  • Components of progressive collapsing foot deformity (PCFD) are interrelated, with the exception of ankle valgus (Class E).
  • Radiographic measurements for PCFD classes demonstrate significant mutual influence, supporting a complex, three-dimensional model of the deformity.
  • The findings suggest that PCFD's ostensibly independent features may be interconnected, impacting treatment strategies.