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Objectives: The etiology of flatfoot and cavus foot is multicausal and controversial. So far, no literature reports the relationship between the sagittal morphology of subtalar joint and the alignment of foot. The purpose of this study was to explore whether the subtalar alignment would influence the configuration of foot., Methods: From January 2017 to January 2020, we included 109 feet in the flatfoot group, 95 feet in the cavus group, and 104 feet in the control group in this retrospective comparative study. The Gissane angle and calcaneal posterior articular surface inclination angle represented the sagittal morphology of the subtalar joint. Meary's angle, calcaneal pitch angle, and talar pitch angle reflected the alignment of foot. They were measured in the weightbearing foot X-rays. The angles in different groups were compared via Mann-Whitney U test. We calculated the correlation between the sagittal alignment of subtalar joint and the alignment of foot using Spearman's correlation analysis. Interobserver and intraobserver reliability were calculated., Results: The Gissane angle, calcaneal posterior articular surface inclination angle, Meary's angle, talar pitch angle, and calcaneal pitch angle were significantly different in the three groups. The Gissane angle had an excellent correlation with the Meary's angle (r = 0.850, p < 0.0001), and the talar pitch angle (r = -0.825, p < 0.0001), and a good correlation with the calcaneal pitch angle (r = 0.638, p < 0.0001). The calcaneal posterior articular surface inclination angle had an excellent correlation with the Meary's angle (r = -0.902, p < 0.001), and the talar pitch angle (r = 0.887, p < 0.0001), and a good correlation with the calcaneal pitch angle (r = -0.702, p < 0.0001). The interobserver and intraobserver reliability for all radiographic measurements was good to excellent., Conclusion: A subtalar joint with a larger Gissane angle and a more horizontal calcaneal posterior articular surface angle tended to have a higher foot arch and vice versa. The inspiration from this study was that the deformities of flatfoot and cavus foot may relate to the subtalar deformity., (© 2024 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Bony alignment is the primary goal in foot and ankle reconstruction of the cavovarus foot. This condition presents as a malalignment causing a medial overload of the ankle articular surface and lateral overload of the hindfoot, midfoot, and forefoot. A painful gait associated with articular degeneration of the numerous joints can lead to a chronic and rigid arthrosis of joints, warranting arthrodesis of the affected joints accordingly., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: The goal of this study was to characterize the abnormal joint surface interaction at the ankle, hindfoot and midfoot joints of the cavovarus foot using distance mapping on weightbearing computed tomography (WBCT) images by comparing a series of cavovarus feet to a series of normally-aligned feet., Methods: In this case-control study, ten feet (10 patients) with asymptomatic cavovarus shape (cases; N = 10) were compared to 10 matched-paired (by age, gender and body mass index) normally-aligned feet (10 patients) (controls; N = 10). Three-dimensional models were produced from the images and distance maps representing joint surface configuration were generated for the ankle, hindfoot and midfoot joints. The distance maps for each joint were then compared between the two groups and between regions in the same group., Results: In the cavovarus group there was a significant increase in surface-to-surface distance at the posterior tibiotalar joint and a reduced distance at the anterior part, together with a greater distance at the posterior half of the medial gutter. Also, a decrease in surface-to-surface distance on the anterior half of the anterior facet and an increased distance on the posterior quadrants of the posterior facet of the subtalar joint were found. At the sinus tarsi, the lateral aspect of the talonavicular joint, the naviculocuneiform and the tarsometatarsal joints there was a statistically significant increase in surface-to-surface distance in cavovarus patients as compared to controls., Conclusion: Distance mapping analysis on WBCT images identified significant differences in surface-to-surface interaction at the foot and ankle joints between cavovarus and normally-aligned feet., Level of Evidence: Level III, case-control study., (Copyright © 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)