Abstract：
The transverse arch (TA) has recently been shown to significantly increase the intrinsic stiffness of the midfoot when coupled with the medial longitudinal arch (MLA). Progressive collapsing foot deformity (PCFD) is a complex deformity that ultimately results in a loss of stiffness and collapse of the MLA. The role of the TA has not been investigated in patients diagnosed with this disorder using weightbearing CT (WBCT). Therefore, this study aims to answer the following questions: (1) Is the curvature of the TA decreased in PCFD? (2) Where within the midfoot does TA curvature flattening happen in PCFD?
A retrospective review of weightbearing CT images was conducted for 32 PCFD and 32 control feet. The TA curvature was assessed both indirectly using previously described methods and directly using a novel measurement termed the transverse arch plantar (TAP) angle that assesses the angle formed between the first, second, and fifth metatarsals in the coronal plane. Location of TA collapse was also assessed in the coronal plane.
The TAP angle was significantly higher in PCFD (mean 115.2 degrees, SD 10.7) than in the control group (mean 100.8 degrees, SD 7.9) (P < .001). No difference was found using the calculated normalized TA curvature between PCFD (mean 17.1, SD 4.8) and controls (mean 18.3, SD 4.0) (P = .266). Location of collapse along the TA in PCFD was most significant at the second metatarsal and medial cuneiform.
The TA is more collapsed in PCFD compared to controls. This collapse was most substantial between the plantar medial cuneiform and the plantar second metatarsal. This may represent a location of uncoupling of the TA and MLA.
Level III, retrospective case control.
A retrospective review of weightbearing CT images was conducted for 32 PCFD and 32 control feet. The TA curvature was assessed both indirectly using previously described methods and directly using a novel measurement termed the transverse arch plantar (TAP) angle that assesses the angle formed between the first, second, and fifth metatarsals in the coronal plane. Location of TA collapse was also assessed in the coronal plane.
The TAP angle was significantly higher in PCFD (mean 115.2 degrees, SD 10.7) than in the control group (mean 100.8 degrees, SD 7.9) (P < .001). No difference was found using the calculated normalized TA curvature between PCFD (mean 17.1, SD 4.8) and controls (mean 18.3, SD 4.0) (P = .266). Location of collapse along the TA in PCFD was most significant at the second metatarsal and medial cuneiform.
The TA is more collapsed in PCFD compared to controls. This collapse was most substantial between the plantar medial cuneiform and the plantar second metatarsal. This may represent a location of uncoupling of the TA and MLA.
Level III, retrospective case control.
摘要：
■最近显示出横向弓（TA）在与内侧纵向弓（MLA）耦合时显着增加了中足的固有刚度。进行性塌陷性足部畸形（PCFD）是一种复杂的畸形，最终导致MLA失去刚度和塌陷。尚未在使用负重CT（WBCT）诊断为该疾病的患者中研究TA的作用。因此,本研究旨在回答以下问题：（1）PCFD中TA的曲率是否降低？（2）PCFD中TA曲率平坦发生在中足的何处？
方法：对32只PCFD和32只对照足的负重CT图像进行了回顾性回顾。使用先前描述的方法间接评估TA曲率，并直接使用称为横向足弓（TAP）角度的新颖测量，该测量评估第一足弓之间形成的角度。第二,第五跖骨位于冠状平面。还在冠状平面中评估了TA塌陷的位置。
■PCFD的TAP角度明显更高（平均115.2度，SD10.7）比对照组（平均100.8度，标准差7.9）（P<.001）。使用计算的归一化TA曲率在PCFD(平均值17.1,SD4.8)和对照(平均值18.3,SD4.0)之间没有发现差异(P=0.266)。在PCFD中，沿TA塌陷的位置在第二meta骨和内侧楔形文字中最为重要。
■与对照相比，PCFD中的TA更折叠。这种塌陷在足底内侧楔形文字和足底第二meta骨之间最为严重。这可以表示TA和MLA的解耦位置。
■三级,回顾性病例对照。
方法：对32只PCFD和32只对照足的负重CT图像进行了回顾性回顾。使用先前描述的方法间接评估TA曲率，并直接使用称为横向足弓（TAP）角度的新颖测量，该测量评估第一足弓之间形成的角度。第二,第五跖骨位于冠状平面。还在冠状平面中评估了TA塌陷的位置。
■PCFD的TAP角度明显更高（平均115.2度，SD10.7）比对照组（平均100.8度，标准差7.9）（P<.001）。使用计算的归一化TA曲率在PCFD(平均值17.1,SD4.8)和对照(平均值18.3,SD4.0)之间没有发现差异(P=0.266)。在PCFD中，沿TA塌陷的位置在第二meta骨和内侧楔形文字中最为重要。
■与对照相比，PCFD中的TA更折叠。这种塌陷在足底内侧楔形文字和足底第二meta骨之间最为严重。这可以表示TA和MLA的解耦位置。
■三级,回顾性病例对照。
