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- Talk
- 21/09/2021
- UK
Quantiative Assessment of Dorsal Sagittal Lateral Column Instability in Unilateral Adult Acquired Flatfoot Deformity (AAFD)
Description
This presentation features David Chrastek, a registrar at Queen Elizabeth Hospital in King's Lynn, discussing a study on adult acquired flat foot deformity (AAFD) with a focus on quantifying lateral column instability. He introduces the concept of AAFD affecting all three columns of the foot, with a particular emphasis on the often underappreciated lateral column instability that can occur asymptomatically. Chrastek explains the main mechanisms behind lateral column overload failure, such as first ray instability and spring ligament failure, which contribute to the condition.
The study aimed to evaluate differences in mobility between affected and unaffected feet, particularly in the lateral column, assess medial column instability, and explore differences in instability between specific metatarsals, as well as the effects of calcaneocuboid joint locking on lateral column motion.
In the methodology, Chrastek details patient recruitment, exclusion criteria, assessment techniques for spring ligament laxity, and the use of custom-made equipment to analyze foot movements. Out of original 25 patients screened, 15 were included in the study, with notable results indicating statistically significant increased motion in the lateral column of affected feet. The findings highlight that the greatest instability was at the fourth and fifth metatarsal articulation.
Chrastek concludes the study by emphasizing the increase in motion within the lateral column of feet affected by AAFD, specifying the metrics of this instability, and highlighting the absence of a significant impact from the varus heel on lateral column mobility. The discussion also leads to questions regarding practical applications, further research on non-flat-foot populations, and distinctions between primary and secondary lateral column instability.