Semiautomated Weight-Bearing CT-Based 3D Analysis of Normal Foot and Ankle in a Korean Population: A Comparison With...

BackgroundTo date, most reference data on foot and ankle morphology are derived from Western cohorts, potentially overlooking significant ethnic variation in Asian population. This study utilized 3D weight-bearing computed tomography (WBCT) to establish population-specific reference values of 3D foot and ankle parameters for a Korean cohort and compare these values with published European data.MethodsThis retrospective, cross-sectional study analyzed the asymptomatic contralateral feet of 39 Korean adults (≥18 years old) using WBCT under natural weight-bearing conditions. Automated 3D measurements-including Meary, talonavicular, and Saltzman view angles-were calculated across sagittal, axial, and coronal planes. Results were compared to a published European cohort (n = 100) using Welch t test. For the subgroup analysis, an independent sample t test was used to compare the parameters between male and female participants within the Korean cohort. Pearson correlation analysis was performed to assess the relationship between age and the measured foot parameters.ResultsStatistically significant differences were observed in 18 of the measured parameters between the Korean and European cohorts. The Korean cohort showed a significantly lower sagittal Meary angle, higher talonavicular angle, and lower Saltzman view angle than European data. Analysis of the Korean cohort revealed no significant sex-based differences across most 3D WBCT parameters, except for the sagittal third tarsometatarsal angle. Age was positively correlated with axial Meary angle, Saltzman view angle, and hallux valgus angle.ConclusionThis study provides preliminary 3D WBCT reference values for the adult Korean foot and ankle. The distinct morphologic variations observed between Korean and European populations underscore the need for ethnic-specific reference values. These findings provide a foundational 3D metric for clinical diagnosis and surgical planning in East Asian populations.