Could Failure of the Spring Ligament Complex Be the Driving Force behind the Development of the Adult Flatfoot Deformity?

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• 作者：Geraint Williams ; James Widnall ; Paul Evans ; Simon Platt
• 关键词：3
• 刊名：The Journal of Foot and Ankle Surgery
• 出版年：March-April, 2014
• 年：2014
• 卷：53
• 期：2
• 页码：152-155
• 全文大小：672 K

文摘

We conducted an investigation into the relative associations of magnetic resonance imaging (MRI)-defined pathologic features of the spring ligament and/or tibialis posterior tendon with radiographic evidence of a planovalgus foot position. A total of 161 patient images (MRI and plain radiographs) obtained from the foot and ankle clinic (2008 to 2011) were retrospectively reviewed. All 161 patients (64 male and 97 female; mean age 45.9聽years, range 18 to 86) were included in the analysis. Lateral weightbearing radiographs were analyzed for the talo-first metatarsal angle 鈮?5掳, calcaneal pitch 鈮?20掳, and talocalcaneal angle 鈮?45掳. A positive finding for 鈮?1 measurements identified a radiographic planovalgus position of the foot. The radiographic deformity was analyzed against the MRI evidence of either spring ligament or tibialis posterior tendon pathologic features for significance (p聽<聽.05). Evidence of a spring ligament abnormality was strongly associated with a planovalgus foot position, reaching high levels of statistical significance in all 3 categories of radiographic deformity (odds ratio 9.2, p聽<聽.0001). Abnormalities of the tibialis posterior tendon failed to demonstrate significance, unless grade I changes were excluded, and grade II and III appearances were analyzed in isolation (odds ratio 2.9, p聽=聽.04). Although absolute causal relationships were not tested, this investigation has clearly demonstrated that MRI-defined abnormalities of the spring ligament complex are possibly of at least equal importance to tibialis posterior dysfunction for the presence of a moderate to severe radiographic planovalgus foot position.