Is a Keystone Bone Anomaly The Main Cause of Pes Planus?

Abstract

Background In flexible pes planus, the height of the arcus pedis longitudinalis medialis (APLM) collapses during weight bearing. We think that this may be caused by anomalies in the bones that support the arches against the compression load. For this purpose, the volume (cm3) and superficial area (cm2) ratios of the foot bones were calculated using foot computed tomography (CT) images of individuals with pes planus and compared with healthy individuals Methods Fifteen pes planus patients diagnosed with pes planus in our clinic and with an APLM angle greater than 145 degrees and 15 healthy male participants were included. The foot computed tomography (CT) images of the participants were taken with a General Electric brand IQ model 32 detector CT device in accordance with the bone protocol, with a section thickness of 0.625 mm. Foot bones were segmented from the obtained CT images with the help of the 3D Slicer program. Results The os cuneiforme mediale and os cuneiforme intermedium volume and superficial area ratios of the pes planus group were significantly lower than the control group (p < 0.05). There was no difference between the groups in the volume and superficial area ratios of the other foot bones (p > 0.05). Conclusion We think that pes planus is primarily caused by os cuniforme mediale and os cuneiforme intermedium developmental anomalies, which act as a keystone in the formation of arches.