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Bayıroğlu G, Pisirici P, Feyzioğlu Ö. The effect of different subtalar joint pronation amounts on postural stability, function and lower extremity alignment in healthy individuals. Foot (Edinb) 2024; 60:102123. [PMID: 39096694 DOI: 10.1016/j.foot.2024.102123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION The prone foot posture has a negative effect on postural stability, function, and knee valgus, but to our knowledge, the contribution of the degree of pronation has not been examined. METHODS 39 participants aged 18-40, with Foot Posture Index (FPI) scores between 6-12 and without any pain complaints were included. Participants with 6-9 points were included in the pronation group (PG) (n = 19), and participants with 10-12 points were included in the hyperpronation group (HPG) (n = 20). Static and dynamic postural stability, Foot and Ankle Ability Measure (FAAM), and frontal plane projection angles (FPPA) were measured for all participants. RESULTS The initial data of the participants are distributed homogeneously. In the intergroup evaluation only FPI-1 (p = 0.001; p < 0.05), FPI-4 (p = 0.00; p < 0.05), FPI-5 (p = 0.00; p < 0.05) and FPI-T (p = 0.000; p < 0.05) scores were found significantly different. CONCLUSION Pronation and hyperpronation of the subtalar joint did not lead to a difference in postural stability, function, and knee valgus in healthy individuals. It may be more beneficial to focus on the prone posture rather than the degree of pronation.
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Affiliation(s)
- Gülsüm Bayıroğlu
- Bahçeşehir University, Graduate Education Institute, Physiotherapy and Rehabilitation Master of Science Program, Istanbul, Turkey.
| | - Pelin Pisirici
- Bahçeşehir University, Health Sciences Faculty, Physiotherapy and Rehabilitation Department, Ihlamur Yıldız Caddesi, No:8, Gayrettepe, Beşiktaş, 34353 İstanbul, Turkey.
| | - Özlem Feyzioğlu
- Acıbadem Mehmet Ali Aydınlar University, Health Sciences Faculty, Physiotherapy and Rehabilitation Department, Istanbul, Turkey.
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Folkman MJ, Amakoutou K, Ravichandran A, Ferrell D, Wang DM, Ren BO, Rascoe A, Liu RW. Torsional Deformity Significantly Impacts Lateral Ankle Radiographic Imaging Parameters. Cureus 2024; 16:e59292. [PMID: 38813268 PMCID: PMC11134472 DOI: 10.7759/cureus.59292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/31/2024] Open
Abstract
Background Optimal lateral ankle imaging is important for the diagnosis and treatment of multiple ankle conditions. The effects of limb deformity on lateral ankle imaging are not well described and are clarified in this osteological study. Materials and methods We utilized an osteological collection and imaged all specimens after the first positioning of the talus in the lateral position and positioning the tibia and fibula to match. We then measured the relative positions of the tibia and fibula and their widths to calculate standard ratios. All measurements were evaluated for reliability using intra-class correlation coefficients. Multiple regression analysis determined how patient characteristics, tibial torsion, and medial proximal tibial angle affected various lateral ankle imaging ratios. Results The intra-class correlation coefficient was excellent for all measurements. In the multiple regression analysis, all five imaging ratios had at least one statistically significant outcome. The anterior tibiofibular interval (ATFI)-tibial width (TW) ratio (ATFI:TW) had only one association with sex and had the lowest standard deviation. All other parameters had variation with tibial torsion and/or medial proximal tibia angle (MPTA). The mean ATFI was 1.06 ± 0.21 cm and 1.19 ± 0.23 cm for females and males, respectively. Conclusions Patient sex and tibial torsion impacted the fidelity of lateral imaging parameters. ATFI:TW may pose the greatest utility given its minimal association with deformity parameters and low standard deviation.
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Affiliation(s)
- Matthew J Folkman
- Pediatric Orthopaedics, The University of Toledo College of Medicine and Life Sciences, Toledo, USA
| | - Kouami Amakoutou
- Pediatric Orthopaedics, Rainbow Babies & Children's Hospital, Cleveland, USA
| | - Asha Ravichandran
- Pediatric Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Dre'Marcus Ferrell
- Pediatric Orthopaedics, Case Western Reserve University School of Medicine, Cleveland, USA
| | - David M Wang
- Dermatology, Brigham and Women's Hospital, Boston, USA
| | - Bryan O Ren
- Orthopaedic Surgery, University of Michigan, Ann Arbor, USA
| | - Alexander Rascoe
- Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Raymond W Liu
- Pediatric Orthopaedics, Rainbow Babies & Children's Hospital, Cleveland, USA
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Wang S, Yu J, Lyu J, Zhao D, Zhang C, Huang J, Wang X, Ma X. Statistical shape modeling of mean shape and principal variability of the human talar bone in the Chinese population. J Orthop Surg (Hong Kong) 2023; 31:10225536231206534. [PMID: 37822123 DOI: 10.1177/10225536231206534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
PURPOSE The talar bone plays a crucial role in ankle biomechanics and stability. Understanding the shape variability of the talar bone within specific populations is essential for various clinical applications. In this study, we aimed to investigate the mean shape and principal variability of the human talar bone in the Chinese population using statistical shape modeling (SSM). METHODS CT scans of 214 tali were included to create SSM models. Principal component analysis was used to describe shape variation among the male, female, and overall groups. RESULTS The largest amount of variation among three groups ranges from 17.2%-18.8% of each variation. The first seven principal components (modes) captured 62.4%-67.5% of the cumulative variance. No dominant shape of the talus was found. Male tali generally have a larger size than the female tali, with the exception of the articular surface of the anterior subtalar joint. CONCLUSIONS SSM is an effective method of finding mean shape and principal variability. Considerable variabilities were noticed among these three groups and all principal modes of variation. No dominant talar model was found to represent the majority of tali, regardless the gender. Such information is crucial to improve the current understanding of talar pathologies and their treatment strategies.
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Affiliation(s)
- Shuo Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian Yu
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jinyang Lyu
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Dahang Zhao
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Zhang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhang Huang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
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Ji L, Ding S, Zhang M, Colon Reyes K, Zhu M, Sun C. The Role of First Tarsometatarsal Joint Morphology and Instability in the Etiology of Hallux Valgus: A Case-Control Study. Foot Ankle Int 2023; 44:778-787. [PMID: 37392055 DOI: 10.1177/10711007231175846] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND The morphology of foot joints is widely accepted as a significant factor in the development of various foot disorders. Nevertheless, the role of the first tarsometatarsal joint (TMT1) morphology in hallux valgus (HV) remains unclear, and its impact on TMT1 instability has not been fully explored. This study aimed to investigate the TMT1 morphology and its potential correlation with HV and TMT1 instability. METHODS Weightbearing computed tomography (WBCT) scans of 82 consecutive feet with HV and 79 controls were reviewed in this case-control study. Three-dimensional (3D) models of TMT1 were constructed using Mimics software and WBCT scans. The height of the TMT1 facet (FH) and the superior, middle, and inferior facet width (SFW, MFW, and IFW) were measured on anteroposterior view of the first metatarsal base. On the lateral view, the inferior lateral facet height and angle (ILFH and ILFA) were measured. TMT1 instability was evaluated using the TMT1 angle. RESULTS Compared with the control group, the HV group had a significantly wider MFW (9.9 mm in HV, 8.7 mm in control), lower ILFH (1.7 mm in HV, 2.5 mm in control), smaller ILFA (16.3 degrees in HV, 24.5 degrees in control), and larger TMT1 angle (1.9 degrees in HV, 0.9 degrees in control) (all P < .05). No significant differences were found between the 2 groups in FH, SFW, and IFW (all P > .05). The study identified 4 types of TMT1 morphology: continuous-flat, separated-flat, continuous-protruded, and separated-protruded. The continuous-flat type possessed significantly larger HVA, IMA, and TMT1 angles compared with other types (all P < .001). CONCLUSION This study indicates a potential association between TMT1 morphology and the severity of HV and identifies 4 TMT1 types. Notably, the continuous-flat type is found to be associated with more severe HV and TMT1 instability. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Linfeng Ji
- Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shenglong Ding
- Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mingzhu Zhang
- Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - Mingjie Zhu
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO, USA
| | - Chengyi Sun
- Department of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Kim J, Rajan L, Henry J, Mizher R, Kumar P, Srikumar S, Demetracopoulos C, Ellis S, Deland J. Axial Plane Rotation of the Talus in Progressive Collapsing Foot Deformity: A Weightbearing Computed Tomography Analysis. Foot Ankle Int 2023; 44:281-290. [PMID: 36864751 DOI: 10.1177/10711007231154894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Progressive collapsing foot deformity (PCFD) is recognized as a 3-dimensional deformity centered around the talus. Previous studies have described some features of talar motion in the ankle mortise in PCFD, such as sagging in the sagittal plane or valgus tilt in the coronal plane. However, axial plane alignment of the talus in the ankle mortise in PCFD has not been investigated extensively. The purpose of this study was to examine this axial plane alignment of PCFD vs controls using weightbearing computed tomography (WBCT) images and to determine if talar rotation in the axial plane is associated with increased abduction deformity, as well as to assess the medial ankle joint space narrowing in PCFD that may be associated with axial plane talar rotation. METHODS Multiplanar reconstructed WBCT images of 79 patients with PCFD and 35 control patients (39 scans) were retrospectively analyzed. The PCFD group was divided into 2 subgroups depending on preoperative talonavicular coverage angle (TNC): moderate abduction (TNC 20-40 degrees, n=57) and severe abduction (TNC >40 degrees, n=22). Using the transmalleolar (TM) axis as a reference, the axial alignment of the talus (TM-Tal), calcaneus (TM-Calc), and second metatarsal (TM-2MT) were calculated. Difference between TM-Tal and TM-Calc was calculated to examine talocalcaneal subluxation. A second method to assess talar rotation within the mortise utilized an angle between the lateral malleolus and the talus (LM-Tal) in the axial slices of WBCT. In addition, the prevalence of medial tibiotalar joint space narrowing was assessed. These parameters were compared between the control and PCFD groups, and between moderate and severe abduction groups. RESULTS The talus was significantly more internally rotated with respect to the ankle TM axis and the lateral malleolus in PCFD patients compared to controls, and in the severe abduction group compared with the moderate abduction group, using both measurement methods. Axial calcaneal orientation did not differ between groups. There was significantly greater axial talocalcaneal subluxation in the PCFD group, and this was also greater in the severe abduction group. The prevalence of medial joint space narrowing was higher in PCFD patients. CONCLUSION Our findings suggest that talar malrotation in the axial plane should be considered an underlying feature of abduction deformity in PCFD. The malrotation occurs in both the talonavicular and ankle joints. This rotational deformity should be corrected at the time of reconstructive surgery, especially in cases of severe abduction deformity. In addition, medial ankle joint narrowing was observed in PCFD patients, with a higher prevalence of medial ankle joint narrowing in those with severe abduction. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
| | - Lavan Rajan
- Hospital for Special Surgery, New York, NY, USA
| | | | - Rami Mizher
- Hospital for Special Surgery, New York, NY, USA
| | | | | | | | - Scott Ellis
- Hospital for Special Surgery, New York, NY, USA
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Wollmann JS, Marshall AS, Schrank M, Gruss LT. Tibial torsion and pressures in the feet during walking: Implications for patterns of metatarsal robusticity. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 180:115-126. [PMID: 36790669 DOI: 10.1002/ajpa.24641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 09/07/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The Dmanisi Homo fossils include a tibia with a low degree of torsion and metatarsals with a pattern of robusticity differing from modern humans. It has been proposed that low tibial torsion would cause a low foot progression angle (FPA) in walking, and consequently increased force applied to the medial rays. This could explain the more robust MT III and IV from Dmanisi. Here we experimentally tested these hypothesized biomechanical relationships in living human subjects. MATERIALS AND METHODS We measured transmalleolar axis (TMA, a proxy for tibial torsion), FPA, and plantar pressure distributions during walking in young men (n = 40). TMA was measured externally using a newly developed method. A pressure mat recorded FPA and pressure under the metatarsal heads (MT I vs. MT II-IV vs. MT V). RESULTS TMA is positively correlated with FPA, but only in the right foot. Plantar pressure under MT II-IV does increase with lower TMA, as predicted, but FPA does not affect pressure. Body mass index also influenced plantar pressure distribution. DISCUSSION Lower tibial torsion in humans is associated with slightly increased pressures along the middle rays of the foot during walking, but not because of changes in FPA. Therefore, it is possible that the low degree of torsion in the Dmanisi Homo tibia is related to the unusual pattern of robusticity in the associated metatarsals, but the mechanism behind this relationship is unclear. Future work will explore TMA, FPA, and plantar pressures during running.
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Affiliation(s)
- Jessica S Wollmann
- Department of Anthropological Sciences, Radford University, Radford, Virginia, USA.,Department of Anthropology, University of Toronto, Toronto, Canada
| | - Aubree S Marshall
- Department of Anthropological Sciences, Radford University, Radford, Virginia, USA.,Department of Biology, Radford University, Radford, Virginia, USA.,Department of Anthropology, Michigan State University, East Lansing, Michigan, USA
| | - McKenzie Schrank
- Department of Anthropological Sciences, Radford University, Radford, Virginia, USA.,Department of Biology, Radford University, Radford, Virginia, USA.,Anschutz Medical Campus, University of Colorado, Aurora, Colorado, USA
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Lafuente Sotillos G, Lafuente Fuster B, López Carrero E, Talamino Delgado E. Reflexiones sobre la torsion tibial externa y repercusiones en la biomecánica. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1652/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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