Effect of foot shape on the three‐dimensional position of foot bones

To eliminate some of the ambiguity in describing foot shape, we developed three‐dimensional (3D), objective measures of foot type based on computerized tomography (CT) scans. Feet were classified via clinical examination as pes cavus (high arch), neutrally aligned (normal arch), asymptomatic pes planus (flat arch with no pain), or symptomatic pes planus (flat arch with pain). We enrolled 10 subjects of each foot type; if both feet were of the same foot type, then each foot was scanned (n = 65 total). Partial weightbearing (20% body weight) CT scans were performed. We generated embedded coordinate systems for each foot bone by assuming uniform density and calculating the inertial matrix. Cardan angles were used to describe five bone‐to‐bone relationships, resulting in 15 angular measurements. Significant differences were found among foot types for 12 of the angles. The angles were also used to develop a classification tree analysis, which determined the correct foot type for 64 of the 65 feet. Our measure provides insight into how foot bone architecture differs between foot types. The classification tree analysis demonstrated that objective measures can be used to discriminate between feet with high, normal, and low arches. © 2006 Orthopaedic Research Society. © 2006 Orthopaedic Research Society. This article is a US Government used and, as such, is in the public domain in the United States of America. Published by Wiley Periodicals, Inc. J Orthop Res

[1]  W. Chu,et al.  The use of arch index to characterize arch height: a digital image processing approach , 1995, IEEE Transactions on Biomedical Engineering.

[2]  Patrick J. Heagerty,et al.  MR and CT image fusion of the cervical spine: a noninvasive alternative to CT-myelography , 2005, SPIE Medical Imaging.

[3]  G Geoffroy,et al.  Roentgenographs Study of Cavus Foot Deformity in Friedreich Ataxia Patients: Preliminary Report , 1982, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[4]  R. Maisel,et al.  Computed tomographic analysis of pes cavus. , 1993, Journal of pediatric orthopedics.

[5]  William R Ledoux,et al.  A three-dimensional, anatomically detailed foot model: a foundation for a finite element simulation and means of quantifying foot-bone position. , 2002, Journal of rehabilitation research and development.

[6]  D A Nawoczenski,et al.  Measurement of the medial longitudinal arch. , 1995, Archives of physical medicine and rehabilitation.

[7]  Kirk E. Smith,et al.  Recombinant Adeno-Associated Virus-Mediated Osteoprotegerin Gene Therapy Inhibits Wear Debris-Induced Osteolysis , 2002, The Journal of bone and joint surgery. American volume.

[8]  Kirk E. Smith,et al.  Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy. , 2003, Journal of biomechanics.

[9]  Kirk E. Smith,et al.  Structural Changes in the Forefoot of Individuals with Diabetes and a Prior Plantar Ulcer , 2002, The Journal of bone and joint surgery. American volume.

[10]  E. Welton The Harris and Beath Footprint: Interpretation and Clinical Value , 1992, Foot & ankle.

[11]  Benno M. Nigg,et al.  Footprint Parameters as a Measure of Arch Height , 1992, Foot & ankle.

[12]  B. Sangeorzan,et al.  Effect of Calcaneal Lengthening on Relationships among the Hindfoot, Midfoot, and Forefoot* , 1993, Foot & ankle.

[13]  A Grasso,et al.  [Computed tomography demonstration++ of calcaneal morphotypes in plantar arch abnormalities]. , 1993, La Radiologia medica.

[14]  Lew C. Schon,et al.  Tendon Transfer Combined with Calcaneal Osteotomy for Treatment of Posterior Tibial Tendon Insufficiency: A Radiological Investigation , 1995, Foot & ankle international.

[15]  M. Coughlin,et al.  Evaluation of Morton's theory of second metatarsal hypertrophy. , 2004, The Journal of bone and joint surgery. American volume.

[16]  J T Deland,et al.  Pes Planus in Patients with Posterior Tibial Tendon Insufficiency: Asymptomatic Versus Symptomatic Foot , 1997, Foot & ankle international.

[17]  Colin E. Thomson,et al.  An investigation into the reliability of the valgus index and its validity as a clinical measurement , 1994 .

[18]  B. Sangeorzan,et al.  Subluxation of the talocalcaneal joint in adults who have symptomatic flatfoot. , 1999, The Journal of bone and joint surgery. American volume.

[19]  N. Gould,et al.  Graphing the Adult Foot and Ankle , 1982, Foot & ankle.

[20]  T. Huang,et al.  Subtalar distractional realignment arthrodesis with wedge bone grafting and lateral decompression for calcaneal malunion. , 1998, Journal of Trauma.

[21]  K. Berbaum,et al.  Reliability of Standard Foot Radiographic Measurements , 1994, Foot & ankle international.

[22]  David W. Polly,et al.  Consistency of Visual Assessments of Arch Height among Clinicians* , 1994, Foot & ankle international.

[23]  H J Hillstrom,et al.  Foot type biomechanics. comparison of planus and rectus foot types. , 1996, Journal of the American Podiatric Medical Association.

[24]  P. Cavanagh,et al.  The arch index: a useful measure from footprints. , 1987, Journal of biomechanics.

[25]  T. Einhorn,et al.  The Validity of Measurements Made on Standard Foot Orthoroentgenograms , 1992, Foot & Ankle.

[26]  B. Sangeorzan,et al.  Alterations in Talar Morphology Associated with Adult Flatfoot , 1997, Foot & ankle international.

[27]  David R. Haynor,et al.  Multirigid registration of MR and CT images of the cervical spine , 2004, SPIE Medical Imaging.

[28]  R. Bordelon,et al.  Correction of Hypermobile Flatfoot in Children by Molded Insert , 1980, Foot & ankle.

[29]  L. Staheli,et al.  The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. , 1987, The Journal of bone and joint surgery. American volume.