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Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/59306
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dc.creatorElijah Auchpt_BR
dc.creatorNacime Salomão Barbachan Mansurpt_BR
dc.creatorThiago Alexandre Alvespt_BR
dc.creatorChristopher Cychoszpt_BR
dc.creatorFrancois Lintzpt_BR
dc.creatorAlexandre Leme Godoy-Santospt_BR
dc.creatorDaniel Soares Baumfeldpt_BR
dc.creatorCesar de Cesar Nettopt_BR
dc.date.accessioned2023-10-09T21:18:29Z-
dc.date.available2023-10-09T21:18:29Z-
dc.date.issued2021-
dc.citation.volume42pt_BR
dc.citation.issue6pt_BR
dc.citation.spage768pt_BR
dc.citation.epage775pt_BR
dc.identifier.doi10.1177/1071100720982907pt_BR
dc.identifier.issn10711007pt_BR
dc.identifier.urihttp://hdl.handle.net/1843/59306-
dc.description.resumoBackground: Lateral overload in progressive collapsing foot deformity (PCFD) takes place as hindfoot valgus, peritalar subluxation, and valgus instability of the ankle increase. Fibular strain due to chronic lateral impingement may lead to distraction forces over the distal tibiofibular syndesmosis (DTFS). This study aimed to assess and correlate the severity of the foot and ankle offset (FAO) as a marker of progressive PCFD with the amount of DTFS widening and to compare it to controls. Methods: In this case-control study, 62 symptomatic patients with PCFD and 29 controls who underwent standing weightbearing computed tomography (WBCT) examination were included. Two fellowship-trained blinded orthopedic foot and ankle surgeons performed FAO (%) and DTFS area measurements (mm2). DTFS was assessed semiautomatically on axial-plane WBCT images, 1 cm proximal to the apex of the tibial plafond. Values were compared between patients with PCFD and controls, and Spearman correlation between FAO and DTFS area measurements was assessed. P values of less than .05 were considered significant.Results: Patients with PCFD demonstrated significantly increased FAO and DTFS measurements in comparison to controls. A mean difference of 6.9% (P < .001) in FAO and 10.4 mm2 (P = .026) in DTFS was observed. A significant but weak correlation was identified between the variables, with a Þ of 0.22 (P = .03). A partition predictive model demonstrated that DTFS area measurements were highest when FAO values were between 7% and 9.3%, with mean (SD) values of 92.7 (22.4) mm2.Conclusion: To our knowledge, this was the first study to assess syndesmotic widening in patients with PCFD. We found patients with PCFD to demonstrate increased DTFS area measurements compared to controls, with a mean difference of approximately 10 mm2. A significantly weak positive correlation was found between FAO and DTFS area measurements, with the highest syndesmotic widening occurring when FAO values were between 7% and 9.3%. Our study findings suggest that chronic lateral impingement in patients with PCFD can result in a negative biomechanical impact on syndesmotic alignment, with increased DTFS stress and subsequent widening. Level of Evidence: Level III, retrospective comparative study.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE APARELHO LOCOMOTORpt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofFoot & Ankle International-
dc.rightsAcesso Restritopt_BR
dc.subjectSyndesmosispt_BR
dc.subjectFlatfootpt_BR
dc.subjectProgressive collapsing flatfoot deformitypt_BR
dc.subjectWeightbearing computed tomographypt_BR
dc.subjectFoot and ankle offsetpt_BR
dc.subject.otherAnkle Jointpt_BR
dc.subject.otherFlatfootpt_BR
dc.titleDistal tibiofibular syndesmotic widening in progressive collapsing foot deformitypt_BR
dc.typeArtigo de Periódicopt_BR
dc.url.externahttps://journals.sagepub.com/doi/10.1177/1071100720982907pt_BR
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