-
Journal of Foot and Ankle Research 2017The aim was to develop statistical shape models of the main human tarsal bones that would result in novel representations of cuboid, navicular and talus.
BACKGROUND
The aim was to develop statistical shape models of the main human tarsal bones that would result in novel representations of cuboid, navicular and talus.
METHODS
Fifteen right and 15 left retrospectively collected computed tomography data sets from male individuals, aged from 17 to 63 years, with no known foot pathology were collected. Data were gathered from 30 different subjects. A process of model building includes image segmentation, unifying feature position, mathematical shape description and obtaining statistical shape geometry.
RESULTS
Orthogonal decomposition of bone shapes utilising spherical harmonics was employed providing means for unique parametric representation of each bone. Cross-validated classification results based on parametric spherical harmonics representation showed high sensitivity and high specificity greater than 0.98 for all considered bones.
CONCLUSIONS
The statistical shape models of cuboid, navicular and talus created in this work correspond to anatomically accurate atlases that have not been previously considered. The study indicates high clinical potential of statistical shape modelling in the characterisation of tarsal bones. Those novel models can be applied in medical image analysis, orthopaedics and biomechanics in order to provide support for preoperative planning, better diagnosis or implant design.
Topics: Adolescent; Adult; Humans; Male; Middle Aged; Models, Anatomic; Models, Statistical; Retrospective Studies; Talus; Tarsal Bones; Young Adult
PubMed: 28163787
DOI: 10.1186/s13047-016-0178-x -
International Orthopaedics Sep 2013Hindfoot malunions after fractures of the talus and calcaneus lead to severe disability and pain. Corrective osteotomies and arthrodeses aim at functional rehabilitation... (Review)
Review
Hindfoot malunions after fractures of the talus and calcaneus lead to severe disability and pain. Corrective osteotomies and arthrodeses aim at functional rehabilitation and reduction of pain resulting from post-traumatic arthritis, eccentric loading and impingement due to hindfoot malunion. Preoperative analysis should include the three-dimensional outline of the malunion, the presence of post-traumatic arthritis, non-union, or infection, the extent of any avascular necrosis or comorbidities. In properly selected, compliant patients with intact cartilage cover little or no, AVN, and adequate bone quality, a corrective joint-preserving osteotomy with secondary internal fixation may be carried out. In the majority of cases, realignment is augmented by arthrodesis for post-traumatic arthritis. Fusion is restricted to the affected joint(s) to minimise loss of function. Correction of the malunion is achieved by asymmetric joint resection, distraction and structural bone grafting with corrective osteotomies for severe axial malalignment. Bone grafting is also needed after resection of a fibrous non-union, sclerotic or necrotic bone. Numerous clinical studies have shown substantial functional improvement and high subjective satisfaction rates from pain reduction after corrective osteotomies and fusions for post-traumatic hindfoot malalignment. This article reviews the indications, techniques and results of corrective surgery after talar and calcaneal malunions and nonunions based on an easy-to-use classification.
Topics: Arthrodesis; Calcaneus; Foot Injuries; Fractures, Bone; Fractures, Malunited; Fractures, Ununited; Humans; Magnetic Resonance Imaging; Osteotomy; Talus; Tomography, X-Ray Computed
PubMed: 23912266
DOI: 10.1007/s00264-013-2021-3 -
Journal of Digital Imaging Oct 2009A new method for measuring bone mineral density (BMD) of the tarsal and metatarsals is described using volumetric quantitative computed tomography (VQCT) in subjects...
A new method for measuring bone mineral density (BMD) of the tarsal and metatarsals is described using volumetric quantitative computed tomography (VQCT) in subjects with diabetes mellitus and peripheral neuropathy. VQCT images of a single foot were acquired twice from eight subjects (mean age 51 [11 SD], seven males, one female). The cortical shells of the seven tarsal and five metatarsal bones were identified and semiautomatically segmented from adjacent bones. Volume and BMD of each bone were measured separately from the two acquired scans for each subject. Whole-bone semiautomatic segmentation measurement errors were determined as the root mean square coefficient of variation for the volume and BMD of 0.8% and 0.9%, respectively. In addition to the whole-bone segmentation methods, we performed atlas-based partitioning of subregions within the second metatarsal for all subjects, from which the volumes and BMDs were obtained for each subregion. The subregion measurement BMD errors (root mean square coefficient of variation) within the shaft, proximal end, and distal end were shown to vary by approximately 1% between the two scans of each subject. The new methods demonstrated large variations in BMDs between the 12 bones of the foot within a subject and between subjects, and between subregions within the second metatarsal. These methods can provide an important outcome measure for clinical research trials investigating the effects of interventions, aging, or disease progression on bone loss, or gain, in individual foot bones.
Topics: Adult; Aged; Bone Density; Diabetes Mellitus; Diabetic Neuropathies; Female; Humans; Male; Metatarsal Bones; Middle Aged; Reproducibility of Results; Tarsal Bones; Tomography, X-Ray Computed
PubMed: 18478296
DOI: 10.1007/s10278-008-9118-z -
The Journal of Maternal-fetal &... Dec 2023This study aimed to analyze the ultrasound characteristics of fetal congenital vertical talus (CVT) to provide a detailed basis for the prenatal diagnosis of CVT.
OBJECTIVE
This study aimed to analyze the ultrasound characteristics of fetal congenital vertical talus (CVT) to provide a detailed basis for the prenatal diagnosis of CVT.
METHODS
We retrospectively analyzed the ultrasonographic findings of fetuses with CVT confirmed by X-ray, surgery, or autopsy from 2010 to 2020. Clinical characteristics and ultrasonographic findings of CVT, including foot morphology, ossification center of the calcaneus and talus, associated deformities, and chromosomal test results, were recorded.
RESULTS
Thirteen patients diagnosed with CVT by prenatal ultrasound were confirmed postpartum. Nine cases were bilateral, and four were unilateral. Under two-dimensional ultrasound, 13/13 cases had abnormal foot morphology, and 10 of 13 cases (76.9%) showed that the ossification center of the talus moved downward, and the calcaneus moved laterally. Under three-dimensional ultrasound, 11 cases (84.6%) presented a "rocking chair" appearance, and two cases did not obtain satisfactory three-dimensional image due to oligohydramnios and fetal position. In this group of cases, two cases (15.4%) were isolated CVT, and the other 11 cases (84.6%) were complicated with other abnormalities. Eleven cases of non-isolated CVT and 1 case of isolated CVT were induced, and another patient with isolated CVT had undergone postnatal surgery, which had been followed up for 8 years and recovered well.
CONCLUSIONS
The combination of fetal foot morphology, ossification center position of the calcaneus and talus, and three-dimensional ultrasound can provide a reliable diagnosis of CVT. Furthermore, we should pay more attention to the evaluation of other systemic and chromosomal abnormalities in CVT cases.
Topics: Female; Humans; Pregnancy; Flatfoot; Retrospective Studies; Prenatal Diagnosis; Talus; Ultrasonography, Prenatal
PubMed: 36948222
DOI: 10.1080/14767058.2023.2192323 -
The Journal of International Medical... Dec 2018Tarsal coalition refers to an abnormal fibrous, cartilaginous, or bony connection that develops between two or more tarsal bones. Talocalcaneal coalition and... (Review)
Review
Tarsal coalition refers to an abnormal fibrous, cartilaginous, or bony connection that develops between two or more tarsal bones. Talocalcaneal coalition and calcaneonavicular coalition account for more than 90% of all cases of tarsal coalition. Coalition exists early at birth, but bony connection usually develops during the patient's late growth period. Isolated cases of talonavicular coalition have rarely been reported. We herein report a case involving an 11-year-old patient with an isolated talonavicular coalition from a soft tissue to bony connection who was treated with arthroscopy for ankle arthritis. To our knowledge, this is the first case in which the whole formation of the talonavicular coalition was observed with a series of radiographic and magnetic resonance imaging examinations. The pain caused by the talonavicular coalition was managed by nonoperative treatment, while the ankle pain caused by the arthritis was relieved after ankle arthroscopy. At 6 years postoperatively, the patient remained pain-free while walking for 30 minutes and was satisfied with the operative outcome. Continuous follow-up confirmed that after the formation of talonavicular coalition, the coalition can continue to progress, forming bony talocalcaneal coalition and calcaneocuboid coalition.
Topics: Ankle Joint; Child; Female; Foot Deformities, Congenital; Humans; Osteotomy; Talus; Treatment Outcome
PubMed: 30453800
DOI: 10.1177/0300060518810889 -
Archives of Orthopaedic and Trauma... Nov 2022Progressive collapsing foot deformity (PCFD) is a complex 3-dimensional (3-D) deformity with varying degrees of hindfoot valgus, forefoot abduction, and midfoot varus.... (Review)
Review
BACKGROUND
Progressive collapsing foot deformity (PCFD) is a complex 3-dimensional (3-D) deformity with varying degrees of hindfoot valgus, forefoot abduction, and midfoot varus. The first aim of this study was to perform a 3-D analysis of the talus morphology between symptomatic PCFD patients that underwent operative flatfoot correction and controls. The second aim was to investigate if there is an impact of individual talus morphology on the success of operative flatfoot correction.
METHODS
We reviewed all patients that underwent lateral calcaneal lengthening for correction of PCFD between 2008 and 2018 at our clinic. Radiographic flatfoot parameters on preoperative and postoperative radiographs were assessed. Additionally, 3-D surface models of the tali were generated using computed tomography (CT) data. The talus morphology of 44 flatfeet was compared to 3-D models of 50 controls without foot or ankle pain of any kind.
RESULTS
Groups were comparable regarding demographics. Talus morphology differed significantly between PCFD and controls in multiple aspects. There was a 2.6° increased plantar flexion (22.3° versus 26°; p = 0.02) and medial deviation (31.7° and 33.5°; p = 0.04) of the talar head in relation to the body in PCFD patients compared to controls. Moreover, PCFD were characterized by an increased valgus (difference of 4.6°; p = 0.01) alignment of the subtalar joint. Satisfactory correction was achieved in all cases, with an improvement of the talometatarsal-angle and the talonavicular uncoverage angle of 5.6° ± 9.7 (p = 0.02) and 9.9° ± 16.3 (p = 0.001), respectively. No statistically significant correlation was found between talus morphology and the correction achieved or loss of correction one year postoperatively.
CONCLUSION
The different morphological features mentioned above might be contributing or risk factors for progression to PCFD. However, despite the variety of talar morphology, which is different compared to controls, the surgical outcome of calcaneal lengthening osteotomy was not affected.
LEVEL OF EVIDENCE
III.
Topics: Calcaneus; Flatfoot; Foot; Humans; Osteotomy; Talus
PubMed: 33970321
DOI: 10.1007/s00402-021-03925-w -
British Medical Journal Aug 1973
Topics: Calcaneus; Fractures, Bone; Humans; Occupational Diseases; Prognosis
PubMed: 4723808
DOI: No ID Found -
BMC Musculoskeletal Disorders Apr 2021Major abnormalities of tarsal bone shape after surgical clubfoot treatment are well known from the literature. The Ponseti method has gained widespread acceptance in...
BACKGROUND
Major abnormalities of tarsal bone shape after surgical clubfoot treatment are well known from the literature. The Ponseti method has gained widespread acceptance in primary treatment of congenital clubfeet. Despite the longtime experience, data regarding the development of tarsal bones after this treatment are still rare. The aim of the study was therefore to evaluate radiographic parameters describing tarsal bone shape of clubfeet after Ponseti treatment and compare them to age-matched healthy feet.
METHODS
Twenty two consecutive severe clubfeet in 14 patients were investigated by repeated diagnostic ultrasound during the corrective process. Extent and temporal course of correction were documented with standardized X-rays after a mean follow-up of 12 years (between the ages of 10-14 years) and compared to a group of age-matched normal feet.
RESULTS
Reliability testing for all X-ray parameters showed good to excellent results. In comparison to the control group, all parameters except the radius of the trochlea (RT) were significantly altered in clubfeet with highest differences shown for the anterior talar motion segment (ATM), talonavicular coverage (TNC) and the talometatarsal index (TMT-Index). Differentiation between minor and major deformities showed significant differences only for the front tarsal index (FTI).
CONCLUSIONS
Tarsal bone shape of clubfeet treated by the Ponseti method differs significantly from normal feet. One of the most pronounced and clinically relevant difference of the clubfoot talus compared to the normal talus is the markedly reduced anterior talar motion segment.
Topics: Adolescent; Casts, Surgical; Child; Clubfoot; Follow-Up Studies; Humans; Manipulation, Orthopedic; Reproducibility of Results; Tarsal Bones; Treatment Outcome
PubMed: 33823837
DOI: 10.1186/s12891-021-04193-w -
The British Journal of Radiology Apr 2022To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit.
OBJECTIVE
To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit.
METHODS AND MATERIALS
Patient cohort was obtained by searching the Radiology Information System for children referred for investigation of flatfoot. All patients with flatfoot on weight-bearing radiographs who had undergone MRI were included. Radiographs were classified by a consultant musculoskeletal radiologist as showing no underlying abnormality, talo-calcaneal coalition, calcaneonavicular coalition, accessory navicular or other abnormality. MRI studies were classified similarly by a different consultant musculoskeletal radiologist blinded to the radiographic findings.
RESULTS
33 males and 24 females were included (mean age 12.5 years; range 3-18 years). 24 had bilateral abnormality, so 81 feet were assessed. Radiographs showed no specific abnormality ( = 51), talocalcaneal coalition ( = 6), calcaneonavicular coalition ( = 3), os naviculare ( = 12) or other abnormality ( = 9). MRI showed no specific abnormality ( = 40), talocalcaneal coalition ( = 10), calcaneonavicular coalition ( = 5), os naviculare ( = 12) or other abnormality ( = 14). Assuming MRI as the diagnostic gold-standard, additional relevant diagnostic information was identified in 19 (23.5%) cases, while in the 51 cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality in 31 (60.8%).
CONCLUSION
MRI is a valuable adjunct to weight-bearing radiography for investigating paediatric flatfoot deformity.
ADVANCES IN KNOWLEDGE
MRI is of value in the assessment of paediatric flatfoot, additional diagnostic information to radiography being identified in 23.5% cases, while in 60.8% of cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality.
Topics: Adolescent; Child; Child, Preschool; Female; Flatfoot; Humans; Magnetic Resonance Imaging; Male; Radiography; Retrospective Studies; Synostosis; Tarsal Bones
PubMed: 34919445
DOI: 10.1259/bjr.20210784 -
BMJ Case Reports Feb 2021A 9-year-old girl presented to the emergency department reporting intense pain and inability to bear weight on her left foot after a classmate tripped over it. Imaging...
A 9-year-old girl presented to the emergency department reporting intense pain and inability to bear weight on her left foot after a classmate tripped over it. Imaging studies confirmed a fracture of the cuboid bone due to compression of the lateral column of the foot (also known as nutcracker fracture). The patient was treated surgically, with direct reduction of the compression fracture and definitive fixation with two Kirschner wires. Cuboid nutcracker fracture is rare in children and adolescents, and potential consequences can occur if it is not correctly diagnosed and adequately managed. Literature on this type of fracture is scarce, along with information on treatment options and results over medium-term and long-term follow-up. We describe this case and review the literature on this particular topic.
Topics: Bone Wires; Child; Female; Foot Injuries; Fracture Fixation, Internal; Fractures, Compression; Humans; Tarsal Bones; Tomography, X-Ray Computed
PubMed: 33541960
DOI: 10.1136/bcr-2020-240441