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Features of hindfoot 3D kinetics in flat foot in ankle-joint maximal dorsiflexion and plantarflexion

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

It is difficult to evaluate the kinematics of flat foot from 2D images, and no definitive methods have so far been established to diagnose flat foot. This study evaluated hindfoot kinetics through the progression of posterior tibial tendon dysfunction (PTTD) in patients with stages II and III PTTD flat foot compared with those in normal patients under dorsiflexion and plantarflexion conditions using 3D computed tomography (CT) reconstruction images.

Materials

CT images were taken of 26 normal and 32 flat feet in neutral, plantarflexion, and dorsiflexion positions of the ankle joint, from which 3D virtual models were made of each hindfoot bone. The 3D bone motion of these models was calculated using volume merge methods in three major planes.

Results

Tibiotalar-joint motion in ankle-joint plantarflexion became less plantarflexed (normal −41.2°, stage II −33.5°, stage III −25.3°) and less adducted (normal −13.9°, stage II −10.7°, stage III −5.6°) as the stage progressed. Talocalcaneal-joint motion in stage III became more plantarflexed (normal −0.8°, stage II −3.0°, stage III −8.7°) and more adducted (normal −0.3°, stage II −4.7°, stage III −10.3°) as the stage progressed. Talonavicular-joint motion in stage III became more plantarflexed (normal −7.2°, stage II −7.6°, stage III −14.9°) and more adducted (normal 1.0°, stage II −7.3°, stage III −17.9°) as the stage progressed.

Conclusions

Tibiotalar-joint plantarflexion decreased and talocalcaneal and talonavicular-joint adduction increased in the maximal ankle-joint plantarflexion in stage II in comparison with normal cases. Tibiotalar-joint plantarflexion and adduction were decreased and of the talocalcaneal and talonavicular joints increased in stage III in comparison with stage II cases.

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Acknowledgments

This work was supported by MEXT KAKENHI 21500411.

Conflict of interest

None of the authors have a conflict of interest regarding this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Kan Imai, Kazuya Ikoma, Masahiro Maki, Masamitsu Kido, Yoshiro Tsuji, Ryota Takatori, Daisaku Tokunaga & Toshikazu Kubo

  2. Department of Biomaterials and Biomechanics, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Daisaku Tokunaga

  3. Department of Orthopedic Surgery, Rush University Medical Center, 1725 W. Harrison St Suite 1063, Chicago, IL, 60612, USA

    Nozomu Inoue

  4. Faculty of Life and Medical Science, Doshisha University, 1-3 TataraMiyakodani, Kyotanabe, 610-0394, Japan

    Nozomu Inoue

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  1. Kan Imai
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  2. Kazuya Ikoma
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  3. Masahiro Maki
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  4. Masamitsu Kido
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  6. Ryota Takatori
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  8. Nozomu Inoue
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  9. Toshikazu Kubo
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Corresponding author

Correspondence to Kazuya Ikoma.

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Imai, K., Ikoma, K., Maki, M. et al. Features of hindfoot 3D kinetics in flat foot in ankle-joint maximal dorsiflexion and plantarflexion. J Orthop Sci 16, 638–643 (2011). https://doi.org/10.1007/s00776-011-0103-x

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  • DOI: https://doi.org/10.1007/s00776-011-0103-x

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