Schoen Clinic Munich-Harlaching, Specialist Centre for Foot and Ankle Joint Surgery, Harlachinger Str. 51, 81547, Munich, Germany.
Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, Nussbaumstrasse 20, 80336, Munich, Germany.
BMC Musculoskelet Disord. 2020 Dec 11;21(1):838. doi: 10.1186/s12891-020-03854-6.
Numerous radiographic parameters are described to evaluate juvenile flexible flatfeet. Reference values for these measurements are based on few studies. The purpose of this study was to determine boundary values among the most widely used radiographic measurements to evaluate juvenile flatfeet.
Twenty-two patients with normal hind-, midfoot configuration (group A: control group; 22 ft, mean age: 12,1 years) and 19 patients with flatfoot deformity (group B: study group; 22 ft, mean age: 12,4 years) were retrospectively analyzed. Nine radiographic parameters were measured (Talocalcaneal-angles, Calcaneal-pitch-angle, Costa-Bartani-angle, Talo-metatarsal-I-angles, Talo-first-metatarsal-base-angle, Talo-navicular-coverage, Calcaneus-fifth-metatarsal-angle). ROC curve analysis was used to calculate optimal differentiating thresholds of each parameter.
Four out of nine parameters (TC-dp, TC-lat, Calc-MTV, Calc-P) were not statistically different between the groups and their ability to distinct between normal foot and flatfoot was low (AUC values = 0,660 - 0,819). Calculation of reference values for these parameters was not performed due to threshold ranges between the groups of > 10°. Reference values could be defined only for three parameters: TMTInd >(-)31°, TMTIB >(-)7,5°, TMT-lat > (-)13,5°. The TMTInd was shown to be a very reliable and valid combination of two measurements (TMTIB and TMT-lat) in the differentiation of normal feet and flatfeet (AUC = 0,998).
The calculation of reference values for established radiographic parameters used to evaluate juvenile flatfeet is difficult for most parameters. The TMTInd as a combination of TMTIB and TMT-lat has been shown to be reliable and valuable to distinct normal feet from flatfeet.
有许多影像学参数被用来评估青少年柔韧性平足。这些测量的参考值基于少数研究。本研究的目的是确定最广泛用于评估青少年平足的影像学测量中最常用的测量值的边界值。
回顾性分析 22 例后足、中足形态正常的患者（A 组：对照组；22 足，平均年龄 12.1 岁）和 19 例平足畸形患者（B 组：研究组；22 足，平均年龄 12.4 岁）。测量了 9 个影像学参数（距跟角、跟骨倾斜角、Costa-Bartani 角、距骨第一跖骨角、距骨第一跖骨基底角、距骨-舟骨覆盖角、跟骨第五跖骨角）。使用 ROC 曲线分析计算每个参数的最佳区分阈值。
9 个参数中的 4 个（TC-dp、TC-lat、Calc-MTV、Calc-P）在两组之间无统计学差异，其区分正常足和扁平足的能力较低（AUC 值=0.660-0.819）。由于两组之间的阈值范围>10°，因此无法计算这些参数的参考值。仅可以为三个参数定义参考值：TMTInd＞（-）31°、TMTIB＞（-）7.5°、TMT-lat＞（-）13.5°。TMTInd 作为 TMTIB 和 TMT-lat 的组合，在区分正常足和平足方面显示出非常可靠和有效的（AUC=0.998）。
大多数参数的建立影像学参数用于评估青少年平足的参考值的计算很困难。TMTInd 作为 TMTIB 和 TMT-lat 的组合，已被证明可用于可靠地区分正常足和扁平足。
