背景:胫骨后肌腱(PTT)功能障碍被认为在进行性塌陷性足部畸形(PCFD)中具有重要作用。我们研究的目的是评估PTT状态与PCFD中三维足畸形之间的关系。
方法:纳入25例PCFD患者的记录进行分析。单足跟上升试验阳性或倒置强度不足的患者认为PTT不足。使用负重CT成像的脚和脚踝偏移(FAO)评估了三维足部畸形。后脚外翻,使用后足力矩臂在X射线上评估中足外展和内侧纵弓塌陷,分别为距骨覆盖角和迈里角。Deland和RosenbergMRI分类用于对PTT变性进行分类。
结果:具有PTT赤字(13/25)的PCFD的平均FAO为7.75+/-3.8%,而没有PTT赤字的PCFD的平均FAO为6.68+/-3.9%(p=0.49)。在后足力矩臂和距骨覆盖角度上,这些组之间没有发现显着差异(分别为p=0.54和0.32),而在患有PTT缺陷的PCFD的情况下,Meary\s角显着增加(p=0.037)。MRI上的PTT变性与FAO之间没有发现显着关联。
结论:PCFD相关的三维畸形,后足外翻和中足外展与PTT功能障碍无关。在我们的研究中,PTT功能障碍仅与更严重的内侧纵向弓塌陷有关。考虑到我们的结果,看来PTT不是PCFD的主要贡献者。
方法:三级,回顾性比较研究。
BACKGROUND: Posterior Tibial Tendon (PTT) dysfunction is considered to have an important role in Progressive Collapsing Foot Deformity (PCFD). The objective of our
study was to assess the relationship between
PTT status and three-dimensional foot deformity in PCFD.
METHODS: Records from 25 patients with PCFD were included for analysis. The PTT was considered deficient in patients with a positive single heel rise test or a deficit in inversion strength. Three-dimensional foot deformity was assessed using the Foot and Ankle Offset (FAO) from Weight-Bearing-CT imaging. Hindfoot valgus, midfoot abduction and medial longitudinal arch collapse were assessed on X-Rays using hindfoot moment arm, talonavicular coverage angle and Meary\'s angle respectively. Deland and Rosenberg MRI classifications were used to classify PTT degeneration.
RESULTS: PCFD with PTT deficit (13/25) had a mean FAO of 7.75 + /- 3.8% whereas PCFD without
PTT deficit had a mean FAO of 6.68 + /- 3.9% (p = 0.49). No significant difference was found between these groups on the hindfoot moment arm and the talonavicular coverage angle (respectively p = 0.54 and 0.32), whereas the Meary\'s angle was significantly higher in case of PCFD with PTT deficit (p = 0.037). No significant association was found between
PTT degeneration on MRI and FAO.
CONCLUSIONS: PCFD associated three-dimensional deformity, hindfoot valgus and midfoot abduction were not associated with PTT dysfunction.
PTT dysfunction was only associated with a worse medial longitudinal arch collapse in our
study. Considering our results, it does not appear that PTT is the main contributor to PCFD.
METHODS: Level III, Retrospective Comparative
Study.