Semi-automated 3-dimensional analysis of the normal foot and ankle using weight bearing CT – A report of normal values and bony relationships

Zaidi, Razi; Sangoi, Dhrumin; Cullen, Nicholas; Patel, Shelain; Welck, Matthew; Malhotra, Karan

doi:10.1016/j.fas.2022.12.001

Cited by 14 publications

(21 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,20 Although significantly improved from the preoperative state, the hindfoot axial parameters remained significantly different from normative values. 22 In our study, we achieved improvement of coronal varus deformity in the hindfoot, as exhibited by the significant correction of 22.1 degrees in the Saltzman view angle. Our CMT deformity patients averaged 11.0 degrees of varus preoperatively, corrected to 11.1 degrees of valgus postoperatively.…”

Section: Discussionsupporting

confidence: 52%

“…Angles between bone axes were automatically measured and collected by the software as previously described. 22 For the analysis of hindfoot sagittal alignment, sagittal Meary angle and calcaneal inclination angle (ie, calcaneal pitch angle) were evaluated. To investigate hindfoot axial and coronal alignment, axial talonavicular angle (TNA), axial Meary angle, talar tilt, and Saltzman view angle 17,22 were measured.…”

Section: Wbct Analysis Using 3d Semiautomated Measurementsmentioning

confidence: 99%

“…These are listed alongside normative values using the same software in normal controls and compared. 22 Correlation among variables of preoperative parameters are shown in Table 3. These measurements indicate the correlation of deformities in the different axes.…”

Section: Ct Assessmentmentioning

confidence: 99%

“…18 To date, the effect of joint-sparing CMT cavovarus reconstruction on the 3D anatomy of the foot and ankle has not been analyzed and there had not been normal data defined in the context of semiautomated analysis of WBCT. Recently, Zaidi et al 22 published control data using 3D semiautomated measurements of WBCT on 100 control patients and have provided a template for deformity correction analysis. Therefore, it is now possible to assess deformity correction compared with normative values.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

Song,

Michalski,

Pfeffer

2024

Foot Ankle Int.

View full text Add to dashboard Cite

Background: The complex deformities in cavovarus feet of Charcot-Marie-Tooth (CMT) disease are difficult to evaluate. The aim of this study was to quantify the initial standing alignment correction achieved after joint-sparing CMT cavovarus reconstruction using pre- and postoperative weightbearing computed tomography (WBCT). Methods: Twenty-nine CMT cavovarus reconstructions were retrospectively analyzed. Three-dimensional measurements were performed using semiautomated software (Bonelogic 2.1) to investigate changes in sagittal, axial, and coronal parameters. Pre- and postoperative data were compared, along with normative data. Correlation among the preoperative measurements and the amount of correction in sagittal, axial, and coronal parameters were analyzed. Results The sagittal, axial, and coronal malalignment of the hindfoot, and the sagittal and axial malalignment of the forefoot, was significantly improved after corrective surgery ( P < .05). Sagittal Meary angle (from 14.8 to 0.1 degrees), axial talonavicular angle (TNA, from 3.6 to 19.2 degrees), and coronal hindfoot alignment (from 11.0 to −11.1 degrees) showed significant changes postoperatively ( P < .001). Hindfoot, forefoot sagittal, and forefoot axial parameters reached comparable outcomes compared with normative value ( P > .05). Regarding amount of correction, Spearman correlation demonstrated that axial Meary angle and TNA were most strongly related to improvement in sagittal Meary angle and coronal hindfoot alignment. Conclusion: Preoperative and postoperative WBCT measurements demonstrated that joint sparing CMT cavovarus reconstruction significantly improved sagittal, axial, and coronal deformities of CMT, and sagittal Meary angle was restored toward normative values. Apparent axial plane correction, the majority of which occurred at the talonavicular joint, had the strongest correlation with deformity correction in multiple planes. This suggests that soft tissue releases and correction of the talonavicular joint may be a key component of a cavovarus foot correction. Level of Evidence: Level IV, retrospective case series.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Wbct Analysis Using 3d Semiautomated Measurementsmentioning

confidence: 99%

Section: Ct Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

Song,

Michalski,

Pfeffer

2024

Foot Ankle Int.

View full text Add to dashboard Cite

show abstract

“…[3, 22] The recent advent of weightbearing cone‐beam CT (WBCT) overcomes these drawbacks by imaging both ankles during bipedal loading [2, 7, 25]. Software‐based techniques, utilized to generate models of bones and calculate their axes within a three‐dimensional framework, have previously demonstrated high efficacy and accuracy in assessing the spatial orientation and detecting landmarks of ankle bones [28, 37]. Despite these technological advances, it remains debated whether syndesmotic ankle injuries should be imaged under weightbearing conditions and/or during application of external rotation [6, 19, 31].…”

Section: Introductionmentioning

confidence: 99%

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight‐bearing CT

Peiffer,

Dhont,

Cuigniez

et al. 2023

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

Purpose Acute syndesmotic ankle injuries continue to impose a diagnostic dilemma and it remains unclear whether weightbearing and/or external rotation should be added during the imaging process. Therefore, the aim of this study was to assess if combined weightbearing and external rotation increases the diagnostic sensitivity of syndesmotic ankle instability using weightbearing CT (WBCT) imaging, compared to isolated weightbearing. Methods In this retrospective study, patients with an acute syndesmotic ankle injury were analysed using a WBCT (N = 21; Age = 31.6 ± 14.1 years old). Inclusion criteria were an MRI conirmed syndesmotic ligament injury imaged by a WBCT of the ankle during weightbearing and combined weightbearing-external rotation. Exclusion criteria consisted of fracture associated syndesmotic injuries. Three-dimensional (3D) models were generated from the CT slices. Tibioibular displacement and talar rotation were quantiied using automated 3D measurements (anterior tibioibular distance (ATFD), Alpha angle, posterior Tibioibular distance (PTFD) and Talar rotation (TR) angle in comparison to the contralateral non-injured ankle. ResultsThe diference in neutral-stressed Alpha angle and ATFD showed a signiicant diference between patients with a syndesmotic ankle lesion and contralateral control (P = 0.046 and P = 0.039, respectively). The diference in neutral-stressed PTFD and TR angle did not show a signiicant diference between patients with a syndesmotic ankle lesion and healthy ankles (n.s.). Conclusion Application of combined weightbearing-external rotation reveals an increased ATFD in patients with syndesmotic ligament injuries. This study provides the irst insights based on 3D measurements to support the potential relevance of applying external rotation during WBCT imaging. In clinical practice, this could enhance the current diagnostic accuracy of subtle syndesmotic instability in a non-invasive manner. However, to what extent certain displacement patterns require operative treatment strategies has yet to be determined in future studies. Level of evidence Level III.

show abstract

The position, orientation, and relative size of the fibularis longus tubercle in normal patients: A weightbearing CT assessment

Ardakani,

Rudran,

Stringer

et al. 2024

Clinical Anatomy

View full text Add to dashboard Cite

The fibularis longus attaches to the base of the first metatarsal at the fibularis/peroneus longus tubercle (FLT/PLT). Theoretically, differences in FLT morphology may reflect changes in the function of the fibularis longus. This study defines the normal limits of the FLT position, orientation, and size in patients with morphologically normal foot anatomy. A retrospective analysis of 131 feet without deformity in 72 patients undergoing weightbearing CT (WBCT) at a single center was conducted. The position and morphology of the FLT was assessed with novel measurements including tubercle‐floor distance, tubercle‐metatarsal angle, and the angle between the floor and a line bisecting the FLT (bisecting angle). Roundness of the FLT was compared to a triangle limiting its shape (triangular ratio), with lower values indicating increasing roundness. We also report relative size of the FLT to the first metatarsal (X/Y ratio), and relative size of the first metatarsal and FLT to the second metatarsal (XY/Z ratio). There were no significant side to side differences for any measurement (p > 0.05). Mean values were: tubercle‐floor distance 28.02 ± 2.63 mm, tubercle‐metatarsal angle 32.7 ± 6.32 degrees, bisecting angle 65.58 ± 6.27 degrees, triangular ratio 0.69 ± 0.04, X/Y ratio 1.13 ± 0.20, and XY/Z ratio 3.44 ± −0.72. Bisecting angle strongly correlated with tubercle‐metatarsal angle (Pearson correlation 0.840, p < 0.001) suggesting FLT rotation occurred independent of foot position. ICC was >0.943 for all measurements. This study reports the morphology of the FLT in individuals with normal feet. This normative data may be used in future studies examining differences between groups of patients with foot pathology, helping us better understand the role of fibularis longus in the development and treatment of foot disorders.

show abstract

Semi-automated 3-dimensional analysis of the normal foot and ankle using weight bearing CT – A report of normal values and bony relationships

Cited by 14 publications

References 17 publications

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

3D Analysis of Joint-Sparing Charcot-Marie-Tooth Surgery Effect on Initial Standing Foot Alignment

Application of external torque enhances the detection of subtle syndesmotic ankle instability in a weight‐bearing CT

The position, orientation, and relative size of the fibularis longus tubercle in normal patients: A weightbearing CT assessment

Contact Info

Product

Resources

About