AI Article Synopsis
- The study aimed to analyze progressive collapsing foot deformity (PCFD) using 3D distance mapping from weightbearing CT scans, focusing on peritalar subluxation (PTS).
- Findings revealed significant uncoverage in the middle facet of the foot in PCFD patients, while anterior and posterior facets showed no such changes, reinforcing previous 2D studies that highlighted the importance of the middle facet in assessing PTS.
- The research concluded that objective distance mapping provides a clearer and more consistent measurement of PTS in patients with PCFD, suggesting it as a valuable tool in clinical evaluations.
Article Abstract
Background: Progressive collapsing foot deformity (PCFD), formerly termed , is a complex 3-dimensional (3D) deformity of the foot characterized by peritalar subluxation (PTS). PTS is typically measured at the posterior facet, but recent studies have called this into question. The objective of this study was to use 3D distance mapping (DM) from weightbearing computed tomography (WBCT) to assess PTS in patients with PCFD and controls. We hypothesized that DMs would identify the middle facet as a superior marker for PTS.
Methods: We analyzed WBCT data of 20 consecutive stage I patients with PCFD and 10 control patients with a novel DM technique to objectively characterize joint coverage across the entire peritalar surface, including both articular and nonarticular regions. Joint coverage was defined as the percentage of articular area with DMs <4 mm and impingement when distances were <0.5 mm. Comparisons were performed with independent tests or Wilcoxon tests. values <.05 were considered significant.
Results: Overall, coverage was decreased in articular regions and impingement was increased in nonarticular regions of patients with PCFD with a significant increase in uncoverage in the middle (46.6%, < .001) but not anterior or posterior facets. Significant increases in sinus tarsi coverage were identified (98.0%, < .007) with impingement in 6 of 20 patients with PCFD. Impingement of the subfibular region was noted in only 1 of 20 cases but narrowing greater than 2 standard deviations was noted in 17 of 20 patients.
Conclusion: Objective DMs identified significant markers of PTS in the middle but not posterior or anterior facets. We confirmed prior 2-dimensional data that suggested uncoverage of the middle facet provided a more robust and consistent measure of PTS than measures in the posterior facet.
Level Of Evidence: Level III, case-control study.
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