CME OnDemand: 2022 AOFAS Annual Meeting-Identification of the Apex of the Medial Longitudinal Arch Break in Progressive Collapsing Foot Disorder

Identification of the Apex of the Medial Longitudinal Arch Break in Progressive Collapsing Foot Disorder

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This study aimed to identify the location of the medial longitudinal arch break in patients with symptomatic flat foot deformity and analyze its relationship with Meary's angle. The researchers conducted a retrospective analysis of patients with pes planus deformities. Lateral radiographs were used to define the apex of the medial arch break as the intersection of the talus and the first metatarsal. The centre of rotation of angulation (CORA) of the medial arch break was documented as Meary's angle. <br /><br />The study found that 50.4% of patients had an isolated apex of deformity, with the talonavicular joint and the naviculocuneiform joint being the most common locations. The remaining 49.5% had a combination of apices, with the talonavicular joint being the primary location. The majority of deformities occurred distal to the spring ligament and posterior tibial insertion. <br /><br />There was no statistical difference in Meary's angle between the isolated and combination apices groups. The researchers concluded that the medial arch breaks in over 3/4 of patients occurred distal to the talonavicular joint, indicating the importance of the naviculo-cuneiform joint in reconstruction procedures.

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Lizzy Weigelt, Matthew Philpott, Gerry Kelly, Sarang P. Kasture, Lyndon W. Mason, MB, BCh, MRCS(Eng), FRCS(TR&Orth), FRCS(Glasg), Andrew P. Molloy, MB, ChB, FRCS(Tr&Orth)

Keywords

medial longitudinal arch break

symptomatic flat foot deformity

Meary's angle

pes planus deformities

lateral radiographs

talonavicular joint

naviculocuneiform joint

centre of rotation of angulation (CORA)

spring ligament

reconstruction procedures