Department of Orthopedic Surgery, University of Colorado School of Medicine, 12631 East 17th Avenue, B202, Aurora, CO 80045, USA.
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Foot Ankle Int. 2020 Oct;41(10):1271-1276. doi: 10.1177/1071100720950722. Epub 2020 Aug 28.
The historical nomenclature for the adult acquired flatfoot deformity (AAFD) is confusing, at times called posterior tibial tendon dysfunction (PTTD), the adult flexible flatfoot deformity, posterior tibial tendon rupture, peritalar instability and peritalar subluxation (PTS), and progressive talipes equinovalgus. Many but not all of these deformities are associated with a rupture of the posterior tibial tendon (PTT), and some of these are associated with deformities either primarily or secondarily in the midfoot or ankle. There is similar inconsistency with the use of classification schemata for these deformities, and from the first introduced by Johnson and Strom (1989), and then modified by Myerson (1997), there have been many attempts to provide a more comprehensive classification system. However, although these newer more complete classification systems have addressed some of the anatomic variations of deformities encountered, none of the above have ever been validated. The proposed system better incorporates the most recent data and understanding of the condition and better allows for standardization of reporting. In light of this information, the consensus group proposes the adoption of the nomenclature "Progressive Collapsing Foot Deformity" (PCFD) and a new classification system aiming at summarizing recent data published on the subject and to standardize data reporting regarding this complex 3-dimensional deformity.
Level V, consensus, expert opinion.
We will rename the condition to Progressive Collapsing Foot Deformity (PCFD), a complex 3-dimensional deformity with varying degrees of hindfoot valgus, forefoot abduction, and midfoot varus.Delegate vote: agree, 100% (9/9); disagree, 0%; abstain, 0%.(Unanimous, strongest consensus) Our current classification systems are incomplete or outdated.Delegate vote: agree, 100% (9/9); disagree, 0%; abstain, 0%.(Unanimous, strongest consensus) MRI findings should be part of a new classification system.Delegate vote: agree, 33% (3/9); disagree, 67% (6/9); abstain, 0%.(Weak negative consensus) Weightbearing CT (WBCT) findings should be part of a new classification system.Delegate vote: agree, 56% (5/9); disagree, 44% (4/9); abstain, 0%.(Weak consensus) A new classification system is proposed and should be used to stage the deformity clinically and to define treatment.Delegate vote: agree, 89% (8/9); abstain, 11% (1/9).(Strong consensus).
成人获得性扁平足畸形（AAFD）的历史命名法令人困惑，有时称为后胫肌腱功能障碍（PTTD）、成人柔韧性扁平足畸形、后胫肌腱断裂、距下不稳定和距下半脱位（PTS）以及进行性马蹄内翻足。这些畸形中有许多（并非全部）与后胫肌腱（PTT）断裂有关，其中一些与中足或踝关节的主要或次要畸形有关。这些畸形的分类方案也存在类似的不一致性，从约翰逊和斯特罗姆（1989 年）首次引入的方案，然后由迈尔森（1997 年）修改，已经有许多尝试提供更全面的分类系统。然而，尽管这些更新、更完整的分类系统解决了遇到的一些畸形的解剖变异，但没有一个得到验证。所提出的系统更好地结合了该疾病的最新数据和理解，并更好地允许报告的标准化。有鉴于此，共识小组建议采用“进行性塌陷足畸形”（PCFD）这一命名，并采用一种新的分类系统，旨在总结该主题已发表的最新数据，并使有关这种复杂三维畸形的数据报告标准化。
V 级，共识，专家意见。
我们将该病更名为进行性塌陷足畸形（PCFD），这是一种复杂的三维畸形，具有不同程度的后足外翻、前足外展和中足内翻。
同意，100%（9/9）；不同意，0%；弃权，0%。（一致，最强共识）
我们目前的分类系统不完整或过时。
同意，100%（9/9）；不同意，0%；弃权，0%。（一致，最强共识）
磁共振成像（MRI）发现应成为新分类系统的一部分。
同意，33%（3/9）；不同意，67%（6/9）；弃权，0%。（弱负共识）
负重 CT（WBCT）发现应成为新分类系统的一部分。
同意，56%（5/9）；不同意，44%（4/9）；弃权，0%。（弱共识）
提出了一种新的分类系统，应用于临床分期畸形，并定义治疗方法。
同意，89%（8/9）；弃权，11%（1/9）。（强烈共识）。
