Load Response of the Tarsal Bones in Patients with Flatfoot Deformity: In Vivo 3D Study

Abstract

The method used in this study might be applied to clinical analysis of foot diseases such as the staging of flatfoot and to biomechanical analysis to evaluate the effects of foot surgery in the future.

In vivo three-dimensional analysis of hindfoot kinematics in stage II PTTD flatfoot

“…Typical anatomical changes associated with PTTD flatfoot include the lateral translation of the navicular bone on the talus in a dorsoplantar view, as well as calcaneal eversion and adduction. Also, the calcaneus pronates in a posteroanterior view and the talar head depresses [26]. When PTTD is prolonged and has progressed to stage II, then the spring ligament, the articular capsule of the talonavicular joint, and the deltoid ligament become relaxed, resulting in eversion in the hindfoot and adduction in the forefoot.…”

“…Talonavicular joint motion was defined as the deviation of the navicular relative to the talus; talocalcaneal and calcaneocuboid joint motion was defined as calcaneus relative to the talus and cuboid relative to the calcaneus, respectively [22,26]. Segmental motions of each joint from initial position to terminal position condition were calculated from these translations and rotations of each bone.…”

Correlation between hindfoot joint three-dimensional kinematics and the changes of the medial arch angle in stage II posterior tibial tendon dysfunction flatfoot

“…Talonavicular and talocalcaneal joint movements are defined as the deviation of the navicular and calcaneus relative to the talus, respectively. Calcaneocuboid joint movement is defined as the deviation of the cuboid relative to the calcaneus (Imai et al, 2009;Kido et al, 2011). A global X-Y-Z coordinate system corresponding to anatomical axes was used to describe the orientation of the tarsal bones.…”

“…Wen et al (2012) reported that the rotational and translational change of the talocalcaneal joint had little influence on the change of the MLA. In addition, several studies (Imai et al, 2009;Imai et al, 2011;Kido et al, 2011;Ledoux et al, 2006) and our previous study (Zhang et al, 2013) had investigated the rotational and translational change of these three joints under loading in both healthy foot and stage II PTTD flatfoot, using three-dimensional reconstructed loading CT image data. However, to the best of our knowledge, no previous study had reported the correlation between the kinematics of the talocalcaneal joint, the talonavicular joint and the calcanocuboid joint and the change of the …”

PedCAT for Radiographic 3D-Imaging in standing position

“…The red lines are corresponding to the axial reformation in the red frame, the green lines are corresponding to the parasagittal reformation in the green frame, and the blue lines are corresponding to the coronal reformation in the blue frame. exact analysis within the 3D data that is not influenced by projection and/or foot orientation but lacks weight bearing [5,9]. PedCAT (Curvebeam, Warrington, USA) is a new technology that allows 3D-imaging with full weight bearing which should be not influenced by projection and/or foot orientation (Figures 1 and 2).…”