Is Lateral Impingement a Good Predictor of Peritalar Subluxation in Patients with Adult Acquired Flatfoot Deformity?

Autor: Daniel Baumfeld MD, Thiago A. Silva MD, Shuyuan Li MD, PhD, Alexandre L. Godoy-Santos MD, Francois Lintz MD, Nacime S. Mansur MD, Kevin N. Dibbern PhD, John E. Femino MD, Cesar de Cesar Netto MD, PhD
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 5 (2020)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011420S00021
Popis: Category: Ankle Arthritis; Ankle; Hindfoot; Other Introduction/Purpose: Sinus tarsi and Subfibular impingement are considered the main causes of lateral foot pain in patients with Adult Acquired Flatfoot Deformity (AAFD). They are considered important markers in the spectrum of progressive peritalar subluxation (PTS) in patients with AAFD. Recent literature has also highlighted the use of the Middle Facet of the subtalar joint as a more accurate indicator of PTS. The objective of this study was to assess the relationship between lateral impingement and middle facet PTS. Our hypotheses were that patients with sinus tarsi and subfibular impingement would demonstrate more severe PTS than patients with no impingement, and that subfibular impingement would represent a better indicator of pronounced deformity when compared to sinus tarsi impingement. Methods: In this retrospective comparative Cohort Study, we included 110 AAFD patients that underwent standing weightbearing CT (WBCT) as a standard baseline assessment of their foot deformity. The presence or absence of sinus tarsi and subfibular impingements, as well as the incongruence angle and percentage of subluxation of the middle facet of the subtalar joint, were manually measured on multiplanar reconstruction (MPR) WBCT images by a blinded fellowship-trained foot and ankle surgeon. Descriptive statistics were used to describe the rate of sinus tarsi and subfibular impingement as well as mean values for middle facet incongruence angle and subluxation. Wilcoxon test was used to compare the values of PTS at the middle facet in patients with or without sins tarsi and subfibular impingement. A partition prediction model was used to assess the values of middle facet PTS that would foresee a higher risk for lateral impingement. P-values
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