Miyamoto Takuma, Lisonbee Rich J, Knutson Kassidy, Kurokawa Hiroaki, Taniguchi Akira, Tanaka Yasuhito, Lenz Amy L
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo, Kashihara, Nara 6348521, Japan.
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
J Foot Ankle Surg. 2025 Aug 21. doi: 10.1053/j.jfas.2025.08.003.
Progressive collapsing foot deformity (PCFD) represents a multifaceted three-dimensional condition. However, there has been limited discussion regarding how the morphology of each bone affects PCFD.
To determine morphological differences within each bone of the foot and ankle in females affected by PCFD compared to asymptomatic controls.
Comparative cross-sectional study.
We hypothesized the medial column bones would exhibit the most substantial shape differences between groups. We developed multiple statistical shape models (SSMs) to analyze the 3D shape of the distal tibia, distal fibula, talus, calcaneus, navicular, cuboid, cuneiforms, and metatarsals. We quantified and compared results between 23 female PCFD patients and 23 asymptomatic females.
SSM analyses revealed significant modes of variation across several bones. Notably, the fibula showed reduced fibular tip height in PCFD patients. The talus exhibited decreased lateral and posterior processes and an inferior, adducted talar head shift. The calcaneus had a narrowed posterior facet and anteriorly shifted anterior-medial facet. In PCFD patients, the navicular tuberosity was displaced toward the body with medial-inferior articular defects. The cuboid showed increased prominence of the tuberosity and beak.
These SSM results provide novel characterization of the 3D shape of bones from tibia to metatarsals in PCFD and asymptomatic females. Patients with PCFD exhibited distinct 3D shape differences in the distal fibula, talus, calcaneus, navicular, and cuboid, suggesting that PCFD is primarily characterized by deformities of the hindfoot bones.
进行性足部塌陷畸形（PCFD）是一种多方面的三维病症。然而，关于每块骨头的形态如何影响PCFD的讨论有限。
确定与无症状对照相比，受PCFD影响的女性足踝部各块骨头的形态差异。
比较性横断面研究。
我们假设内侧柱骨在两组之间会表现出最显著的形状差异。我们开发了多个统计形状模型（SSM）来分析胫骨远端、腓骨远端、距骨、跟骨、舟骨、骰骨、楔骨和跖骨的三维形状。我们对23名女性PCFD患者和23名无症状女性的结果进行了量化和比较。
SSM分析揭示了几块骨头的显著变异模式。值得注意的是，PCFD患者的腓骨显示腓骨尖高度降低。距骨表现为外侧和后侧突起减少以及距骨头向下、内收移位。跟骨的后关节面变窄，前内侧关节面前移。在PCFD患者中，舟骨粗隆向身体移位，伴有内侧下关节面缺损。骰骨显示粗隆和喙的突出增加。
这些SSM结果提供了PCFD患者和无症状女性从胫骨到跖骨的骨头三维形状的新特征。PCFD患者在腓骨远端、距骨、跟骨、舟骨和骰骨表现出明显的三维形状差异，表明PCFD主要特征是后足骨畸形。
