Quelle est la méthode radiographique la plus fiable pour évaluer l’arche plantaire médiale ? Application sur une population d’adolescents souffrant d’une scoliose idiopathique - 11/11/20
What is the most reliable radiographic method to evaluate the longitudinal foot arch? Application in subjects with adolescent idiopathic scoliosis
Abstract |
Background |
The foot arch is known to be altered in subjects with postural malalignment. Foot arch morphology can be studied simultaneously with body's balance by measuring foot radiographic parameters on full-body biplanar x-rays. There is no consensus on which is the most reliable method to use to draw the foot axes. The aim was to determine the most reliable methods to draw the main foot axes and apply these findings in order to study the difference of foot parameters between adolescent idiopathic scoliosis (AIS) and control subjects.
Hypotheses |
1) distant and clear anatomical landmarks are needed to draw the foot axes accurately; 2) foot longitudinal arch parameters differ between AIS and controls.
Methods |
In total, 90 AIS patients and 36 controls have undergone full body biplanar X-rays from which 3D spino-pelvic and postural parameters were collected for each patient. Six radiological foot angles were evaluated on the 2D lateral radiographs: calcaneal pitch (CPA), talar declination (TDA), first metatarsal declination (FMDA), talo-calcaneal (TCA), calcaneal first metatarsal (CFMA) and Meary. Angles were calculated based on three major axes of the foot: talar, calcaneal, and first metatarsal. Two to three methods were used to draw each axis and the reliability of each method was assessed (3 operators, 2-times each). Then, differences of the foot parameters between AIS and controls, and determinants of these differences among 3D spino-pelvic and postural parameters were evaluated.
Results |
The most reliable methods for drawing the three axes of the foot were those using distant and clear anatomical landmarks on talus, calcaneum and first metatarsal and used for the subsequent analysis. The AIS group showed a significantly lower TDA (22° vs. 24°, p=0.014) and CFMA (141° vs. 144°, p=0.045), and higher FMDA (18° vs. 15°, p=0.008) and Meary's angle (−5° vs. −9°, p=0.005) when compared to controls. Differences were found to be determined mainly by the center of auditory meatus sagittal plumbline.
Discussion |
This is the first study to evaluate the most reliable method to draw foot axes on the lateral radiograph of biplanar X-rays in order to assess radiological foot arch parameters. AIS patients were shown to have more elevated foot arch compared to controls.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Adolescent Idiopathic Scoliosis, 3D reconstruction, Foot arch, Posture, Repeatability
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 106 - N° 7
P. 785 - novembre 2020 Ritorno al numero
Articolo precedente
- Modifications de l’alignement sagittal thoracique après traitement prolongé par corset pour scoliose idiopathique
- Zheng Zhang, Xiao Ma, Jia Yin, Lun Shu, Rui Gao, Jun Ma, Xuhui Zhou
- Influence de la densité de bandes sous-lamaires dans le traitement des scolioses idiopathiques Lenke 1 de l’adolescent
- Pierre Laumonerie, Meagan E Tibbo, Panagotis Kerezoudis, Tristan Langlais, Jérôme Sales de Gauzy, Franck Accadbled
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