Ramsay Générale de Santé, Foot and Ankle Surgery Center, Clinique de l'Union, Saint-Jean, France.
Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
Foot Ankle Int. 2019 Oct;40(10):1175-1181. doi: 10.1177/1071100719858309. Epub 2019 Jun 28.
Varus hindfoot deformity may increase the risk of chronic lateral ankle instability (CLAI). Our aim was to analyze hindfoot alignment (HFA) in patients with CLAI using weight-bearing cone beam computed tomography (WBCT) to assess this risk.
This retrospective, comparative analysis was carried out using an existing WBCT database (Talas, CurveBeam LLC), including data sets for 370 consecutive feet (189 patients) obtained between July 2016 and October 2018 at a single institution. The software provided semiautomated measurement of HFA, given as foot ankle offset (FAO). Univariate analysis was conducted to compare feet with and without CLAI against sex, age, body mass index, and FAO. Significant variables were included in a multivariable logistic model with random effects to take into account correlation between feet of the same patient.
Forty-three feet had CLAI (34 patients). FAO ( = .0009) was significant for CLAI by univariate analysis. Mean FAO was -2.2% ± 5.5% (varus) and + 2.6% ± 4.7% (valgus) with and without CLAI history, respectively. Multivariable logistic regression adjusted for sex and age demonstrated a 35% increased odds ratio (OR) of CLAI per 1% reduction in FAO value (varus) (adjusted OR=0.64, 95% confidence interval [CI]: 0.49-0.84; = .001) and no significant effect of sex (adjusted OR=0.52; = .617) or age (adjusted OR=0.94; = .165) after adjustment for FAO.
A positive relationship was found between varus HFA and the risk to have CLAI. Systematic recording of FAO measurements from WBCT images along with clinical data regarding CLAI history proved successful at quantifying the risk of CLAI.
Level III, retrospective cohort study.
足内翻后足畸形可能会增加慢性外侧踝关节不稳定（CLAI）的风险。我们的目的是使用负重锥形束 CT（WBCT）分析 CLAI 患者的后足对线（HFA），以评估这种风险。
这是一项回顾性对比分析，使用现有的 WBCT 数据库（Talas，CurveBeam LLC），包括 2016 年 7 月至 2018 年 10 月在一家机构获得的 370 例连续足（189 例患者）的数据组。该软件提供了 HFA 的半自动测量，结果表示为足踝偏移（FAO）。单变量分析用于比较有无 CLAI 的足与性别、年龄、体重指数和 FAO 的关系。将有统计学意义的变量纳入多变量逻辑模型，并采用随机效应来考虑同一患者的足部相关性。
43 只足患有 CLAI（34 例患者）。FAO（ =.0009）通过单变量分析对 CLAI 有意义。FAO 的平均值分别为 -2.2%±5.5%（内翻）和 +2.6%±4.7%（外翻），有无 CLAI 病史。调整性别和年龄的多变量逻辑回归显示，FAO 值每降低 1%，CLAI 的发生几率增加 35%（调整后的 OR=0.64，95%置信区间[CI]：0.49-0.84； =.001），性别（调整后的 OR=0.52； =.617）或年龄（调整后的 OR=0.94； =.165）无显著影响。
发现足内翻 HFA 与发生 CLAI 的风险呈正相关。从 WBCT 图像系统地记录 FAO 测量值，并结合 CLAI 病史的临床数据，成功地量化了 CLAI 的风险。
三级，回顾性队列研究。
