Purpose

To assess whether a correlation between the calcaneal pronation angle and the presence of internal plantar arch overload signs (such as upper-medial spring ligament lesion, posterior tibial tendon tenosynovitis, etc.) could lead to a better understanding of coxa pedis pathology.

Material and methods

One hundred ankle MRIs of consecutive patients were retrospectively reviewed measuring the calcaneal pronation angle and either the presence or absence of internal plantar arch overload signs. Next, the association of overload signs with increasing pronation angle was evaluated to establish a cut-off point beyond which coxa pedis pathology could be defined.

Results

The tibial-calcaneal angle values in patients with and without effusion proved to be significantly different (p < 0.0001). The tibial-calcaneal angle values in patients with and without oedema also demonstrated a significant difference (p < 0.0056). Regarding posterior tibial tendon, a significant difference was found between the two groups (p < 0.0001). For plantar fascia enthesopathy, the result was borderline significant (p < 0.054). A linear correlation was found between the value of pronation angle and the extent of spring ligament injury (p < 0.0001). In contrast, no correlation with age was found.

Conclusion

In conclusion, the literature associates medial longitudinal plantar arch overload with posterior tibial tendinopathy and spring ligament complex injuries. Our data show that both injuries are highly correlated with increased calcaneal pronation angle, which could be considered a predictive sign of internal plantar arch overload, prior to the development of the associated signs.

中文翻译：

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足基：跟骨旋前角可以被视为足底内侧弓超负荷的预测标志吗？

目的

评估跟骨旋前角度与足底内弓超负荷体征（如上内侧弹簧韧带病变、胫骨后腱腱鞘炎等）之间的相关性是否有助于更好地了解足底病理学。

材料与方法

对连续患者的 100 份踝关节 MRI 进行回顾性检查，测量跟骨旋前角度以及是否存在足底内弓超负荷迹象。接下来，评估超负荷征象与增加的旋前角度之间的关联，以建立一个截止点，超过该截止点可以定义足底病理学。

结果

有积液和无积液患者的胫骨-跟骨角度值被证明存在显着差异（p  < 0.0001）。有和没有水肿的患者的胫骨-跟骨角度值也显示出显着差异（p  < 0.0056）。关于胫骨后肌腱，两组之间存在显着差异（p  < 0.0001）。对于足底筋膜附着点病变，结果具有临界显着性 ( p  < 0.054)。旋前角度值与弹簧韧带损伤程度之间存在线性相关性（p  < 0.0001）。相反，没有发现与年龄的相关性。

结论

总之，文献将内侧纵跖弓超负荷与胫骨后肌腱病和弹簧韧带复合体损伤联系起来。我们的数据显示，这两种损伤都与跟骨旋前角度的增加高度相关，在相关症状出现之前，这可以被认为是足底内弓超负荷的预测标志。