Quantifying increased lateral column instability in Adult Acquired Flatfoot Deformity (AAFD)
AAFD comprises ligamentous failure and tendon overload, mainly focused on the symptomatic posterior tibial tendon and the spring ligament. Increased lateral column (LC) instability arising in AAFD is not defined or quantified. This study aims to quantify the increased LC motion in unilateral symptom...
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| Veröffentlicht in: | Foot (Edinburgh, Scotland) Scotland), 2023-09, Vol.56, p.102036-102036, Article 102036 |
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| creator | Chrastek, David El-Mousili, Mahmoud Al-Sukaini, Ahmad Austin, Isabel S. Yanduru, Trisha Cutts, Steve Pasapula, Chandra |
| description | AAFD comprises ligamentous failure and tendon overload, mainly focused on the symptomatic posterior tibial tendon and the spring ligament. Increased lateral column (LC) instability arising in AAFD is not defined or quantified. This study aims to quantify the increased LC motion in unilateral symptomatic planus feet, using the contralateral unaffected asymptomatic foot as an internal control. In this case matched analysis, 15 patients with unilateral stage 2 AAFD foot and an unaffected contralateral foot were included. Lateral foot translation was measured as a guide to spring ligament competency. Medial and LC dorsal sagittal instability were assessed by direct measurement of dorsal 1st and 4th/5th metatarsal head motion and further video analysis. The mean increase in dorsal LC sagittal motion (between affected vs unaffected foot) was 5.6 mm (95% CI [4.63–6.55], p |
| doi_str_mv | 10.1016/j.foot.2023.102036 |
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•Adult Acquired Flatfoot Deformity is caused by failure of ligaments and tendons.•A custom-made orthosis with calipers was used to investigate instability.•Video analysis of foot examination was used to further investigate instability.•There is increased motion in the lateral column of the foot in feet affected by AAFD.•Lateral column instability can be treated with orthosis to prevent deterioration.</description><identifier>ISSN: 0958-2592</identifier><identifier>EISSN: 1532-2963</identifier><identifier>DOI: 10.1016/j.foot.2023.102036</identifier><identifier>PMID: 37271102</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Lateral column ; Longitudinal arch ; Pes planus ; Plantar calcaneonavicular ligament ; Spring ligament</subject><ispartof>Foot (Edinburgh, Scotland), 2023-09, Vol.56, p.102036-102036, Article 102036</ispartof><rights>2023 Elsevier Ltd</rights><rights>Copyright © 2023 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c222t-7bd28ed72cf8071bb751b91ddb0bd1b9567069ecc6f8582c1a7b13f173d9b8583</cites><orcidid>0000-0003-2601-8762</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.foot.2023.102036$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37271102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chrastek, David</creatorcontrib><creatorcontrib>El-Mousili, Mahmoud</creatorcontrib><creatorcontrib>Al-Sukaini, Ahmad</creatorcontrib><creatorcontrib>Austin, Isabel S.</creatorcontrib><creatorcontrib>Yanduru, Trisha</creatorcontrib><creatorcontrib>Cutts, Steve</creatorcontrib><creatorcontrib>Pasapula, Chandra</creatorcontrib><title>Quantifying increased lateral column instability in Adult Acquired Flatfoot Deformity (AAFD)</title><title>Foot (Edinburgh, Scotland)</title><addtitle>Foot (Edinb)</addtitle><description>AAFD comprises ligamentous failure and tendon overload, mainly focused on the symptomatic posterior tibial tendon and the spring ligament. Increased lateral column (LC) instability arising in AAFD is not defined or quantified. This study aims to quantify the increased LC motion in unilateral symptomatic planus feet, using the contralateral unaffected asymptomatic foot as an internal control. In this case matched analysis, 15 patients with unilateral stage 2 AAFD foot and an unaffected contralateral foot were included. Lateral foot translation was measured as a guide to spring ligament competency. Medial and LC dorsal sagittal instability were assessed by direct measurement of dorsal 1st and 4th/5th metatarsal head motion and further video analysis. The mean increase in dorsal LC sagittal motion (between affected vs unaffected foot) was 5.6 mm (95% CI [4.63–6.55], p < 0.001). The mean increase in the lateral translation score was 42.8 mm (95% CI [37.48–48.03], p < 0.001). The mean increase in medial column dorsal sagittal motion was 6.8 mm (95% CI [5.7–7.8], p < 0.001). Video analysis also showed a statistically significant increase in LC dorsal sagittal motion between affected and unaffected sides (p < 0.001). This is the first study that quantifies a statistically significant increased LC dorsal motion in feet with AAFD. Understanding its pathogenesis and its link to talonavicular/spring ligament laxity improves foot assessment and may allow the development of future preventative treatment strategies.
•Adult Acquired Flatfoot Deformity is caused by failure of ligaments and tendons.•A custom-made orthosis with calipers was used to investigate instability.•Video analysis of foot examination was used to further investigate instability.•There is increased motion in the lateral column of the foot in feet affected by AAFD.•Lateral column instability can be treated with orthosis to prevent deterioration.</description><subject>Lateral column</subject><subject>Longitudinal arch</subject><subject>Pes planus</subject><subject>Plantar calcaneonavicular ligament</subject><subject>Spring ligament</subject><issn>0958-2592</issn><issn>1532-2963</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kE9Lw0AQxRdRbK1-AQ-Sox5Sdyckm4CX0FoVCiLoTVj2X2RLkm13N0K_vRtaPXqaYeb3HjMPoWuC5wST4n4zb6wNc8CQxQHgrDhBU5JnkEJVZKdoiqu8TCGvYIIuvN9gjHMAOEeTjAIlUTJFn28D74Np9qb_SkwvneZeq6TlQTveJtK2Q9fHhQ9cmNaEfeyTWg1tSGq5G4yL8CrS4yXJUjfWdSN0W9er5d0lOmt46_XVsc7Qx-rxffGcrl-fXhb1OpXxnJBSoaDUioJsSkyJEDQnoiJKCSxU7PKC4qLSUhZNmZcgCaeCZA2hmapEnGQzdHvw3Tq7G7QPrDNe6rblvbaDZ1ACUFzhvIooHFDprPdON2zrTMfdnhHMxlTZho2_sDFVdkg1im6O_oPotPqT_MYYgYcDoOOX30Y75qXRvdQqBiQDU9b85_8Ds6-ImA</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Chrastek, David</creator><creator>El-Mousili, Mahmoud</creator><creator>Al-Sukaini, Ahmad</creator><creator>Austin, Isabel S.</creator><creator>Yanduru, Trisha</creator><creator>Cutts, Steve</creator><creator>Pasapula, Chandra</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2601-8762</orcidid></search><sort><creationdate>20230901</creationdate><title>Quantifying increased lateral column instability in Adult Acquired Flatfoot Deformity (AAFD)</title><author>Chrastek, David ; El-Mousili, Mahmoud ; Al-Sukaini, Ahmad ; Austin, Isabel S. ; Yanduru, Trisha ; Cutts, Steve ; Pasapula, Chandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c222t-7bd28ed72cf8071bb751b91ddb0bd1b9567069ecc6f8582c1a7b13f173d9b8583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Lateral column</topic><topic>Longitudinal arch</topic><topic>Pes planus</topic><topic>Plantar calcaneonavicular ligament</topic><topic>Spring ligament</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chrastek, David</creatorcontrib><creatorcontrib>El-Mousili, Mahmoud</creatorcontrib><creatorcontrib>Al-Sukaini, Ahmad</creatorcontrib><creatorcontrib>Austin, Isabel S.</creatorcontrib><creatorcontrib>Yanduru, Trisha</creatorcontrib><creatorcontrib>Cutts, Steve</creatorcontrib><creatorcontrib>Pasapula, Chandra</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Foot (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chrastek, David</au><au>El-Mousili, Mahmoud</au><au>Al-Sukaini, Ahmad</au><au>Austin, Isabel S.</au><au>Yanduru, Trisha</au><au>Cutts, Steve</au><au>Pasapula, Chandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quantifying increased lateral column instability in Adult Acquired Flatfoot Deformity (AAFD)</atitle><jtitle>Foot (Edinburgh, Scotland)</jtitle><addtitle>Foot (Edinb)</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>56</volume><spage>102036</spage><epage>102036</epage><pages>102036-102036</pages><artnum>102036</artnum><issn>0958-2592</issn><eissn>1532-2963</eissn><abstract>AAFD comprises ligamentous failure and tendon overload, mainly focused on the symptomatic posterior tibial tendon and the spring ligament. Increased lateral column (LC) instability arising in AAFD is not defined or quantified. This study aims to quantify the increased LC motion in unilateral symptomatic planus feet, using the contralateral unaffected asymptomatic foot as an internal control. In this case matched analysis, 15 patients with unilateral stage 2 AAFD foot and an unaffected contralateral foot were included. Lateral foot translation was measured as a guide to spring ligament competency. Medial and LC dorsal sagittal instability were assessed by direct measurement of dorsal 1st and 4th/5th metatarsal head motion and further video analysis. The mean increase in dorsal LC sagittal motion (between affected vs unaffected foot) was 5.6 mm (95% CI [4.63–6.55], p < 0.001). The mean increase in the lateral translation score was 42.8 mm (95% CI [37.48–48.03], p < 0.001). The mean increase in medial column dorsal sagittal motion was 6.8 mm (95% CI [5.7–7.8], p < 0.001). Video analysis also showed a statistically significant increase in LC dorsal sagittal motion between affected and unaffected sides (p < 0.001). This is the first study that quantifies a statistically significant increased LC dorsal motion in feet with AAFD. Understanding its pathogenesis and its link to talonavicular/spring ligament laxity improves foot assessment and may allow the development of future preventative treatment strategies.
•Adult Acquired Flatfoot Deformity is caused by failure of ligaments and tendons.•A custom-made orthosis with calipers was used to investigate instability.•Video analysis of foot examination was used to further investigate instability.•There is increased motion in the lateral column of the foot in feet affected by AAFD.•Lateral column instability can be treated with orthosis to prevent deterioration.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>37271102</pmid><doi>10.1016/j.foot.2023.102036</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2601-8762</orcidid></addata></record> |
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| subjects | Lateral column Longitudinal arch Pes planus Plantar calcaneonavicular ligament Spring ligament |
| title | Quantifying increased lateral column instability in Adult Acquired Flatfoot Deformity (AAFD) |
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