Hindfoot-centred X-ray technique for the evaluation of cavovarus deformity : A proposal for the optimization of radiologic delineation

In surgical correction of cavovarus deformity bony hindfoot procedures are required in most cases. For treatment planning X‑rays in two or more planes are usually used. In conventional X‑ray-techniques the hindfoot and ankle joint are presented in a more or less outward rotated position. Moreover, t...

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Published inDer Orthopäde Vol. 49; no. 6; pp. 531 - 537
Main Authors Hamel, J, Hörterer, H, Gottschalk, O, Harrasser, N, Walther, M
Format Journal Article
LanguageGerman
Published Germany 01.06.2020
Subjects
Ankle joint
Hindfoot inversion
TMT-I-angle
Coleman-blocktest
High-arched foot
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Summary:In surgical correction of cavovarus deformity bony hindfoot procedures are required in most cases. For treatment planning X‑rays in two or more planes are usually used. In conventional X‑ray-techniques the hindfoot and ankle joint are presented in a more or less outward rotated position. Moreover, the peritalar complex is not delineated in the most corrected position. Therefore, the frequently used talus-metatarsal-I-angle (Meary angle) cannot be measured correctly. By application of the Coleman block test and additional adjustment of the malrotation in the lateral view, the peritalar complex and ankle joint can be evaluated in the corrected and "hindfoot-centred" position. Also, the frequently seen anterior ankle impingement can be observed precisely. Planning of osteotomies or corrective peritalar fusions is supported thereby. Some treatment examples are presented.
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ISSN:1433-0431
DOI:10.1007/s00132-019-03800-y