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Morphological changes in flatfoot: a 3D analysis using weight-bearing CT scans
Yuchun Cai1, Zhe Zhao2, Jianzhang Huang1
1The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China.
BMC Medical Imaging
|August 19, 2024
Summary
This study reveals significant three-dimensional (3D) morphological changes in flatfoot, impacting bone structure and force conduction. Weight-bearing CT (WBCT) identified key alterations in foot and ankle angles and heights, aiding in understanding flatfoot development.
Area of Science:
- Orthopedics
- Radiology
- Biomechanics
Background:
- Flatfoot involves complex 3D morphological changes, often underestimated by 2D imaging.
- Previous studies limited by 2D radiographs and non-weight-bearing conditions.
- Understanding 3D bone morphology is crucial for analyzing flatfoot deformity and force conduction.
Purpose of the Study:
- To analyze morphological changes in flatfoot using 3D measurements from weight-bearing CT (WBCT).
- To identify significant risk factors associated with flatfoot development.
Main Methods:
- Retrospective comparative study analyzing WBCT scans from patients with flatfoot symptoms and healthy controls.
- 3D reconstruction of foot models to compare distances, angles (sagittal, transverse, coronal), and volumes between groups.
- Logistic regression, ROC curves, and nomogram used to identify flatfoot risk factors.
Main Results:
- Significant differences observed in calcaneofibular distance, calcaneal inclination, medial column height, and talonavicular/talocalcaneal/Hibb/Meary's angles between flatfoot and healthy groups.
- Flatfoot group showed lower calcaneofibular distance, medial column height, and certain angles.
- Sagittal Hibb angle and medial column height identified as significant risk factors for flatfoot.
Conclusions:
- Findings confirm 3D spatial alterations in flatfoot, including forefoot abduction, arch collapse, midfoot subluxation, and hindfoot/forefoot malalignments.
- WBCT provides valuable 3D insights into the complex structural changes characteristic of flatfoot.
- Identified risk factors can aid in understanding and potentially predicting flatfoot development.
