ArticleArchives of orthopaedic and trauma surgery2023
A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type.Journal of clinical medicine · 2024Review
- Assessment of the Efficiency of Measuring Foot and Ankle Edema with a 3D Portable Scanner.Bioengineering (Basel, Switzerland) · 2023Article
- A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment.Archives of orthopaedic and trauma surgery · 2023Article
- A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment.Archives of orthopaedic and trauma surgery · 2023Article
- Femoral morphology affects postoperative alignment of the lower extremities in hybrid closed-wedge high tibial osteotomy.Archives of orthopaedic and trauma surgery · 2022Article
- Arc center distance as a novel quantitative radiographic parameter for volar Barton fractures.Archives of orthopaedic and trauma surgery · 2022Article
- Changes in joint space width over time and risk factors for deterioration of joint space width after medial opening-wedge high tibial osteotomy.Archives of orthopaedic and trauma surgery · 2022Article
- Lesion size and varus malalignment are the major determinants leading to poorer clinical outcomes after combined microfracture treatment for focal cartilage lesions during anterior cruciate ligament reconstruction.Archives of orthopaedic and trauma surgery · 2022Article
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8 authors.
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Abstract
introductionBluman et al., flatfoot classification is based on posterior tibial tendon (PTT) dysfunction leading to a chronological appearance of several foot deformities. An expert consensus recently proposed a new classification named Progressive Collapsing Foot Deformity (PCFD) in which the focus was shifted to five different independent foot and ankle deformities and their flexibility or rigidity. The aim of this study was to compare Bluman and PCFD classifications. We hypothesize that both classifications will be reliable and that the PCFD classification will allow a larger distribution of the different types of foot deformity. MATERIALS AND
methodsWe performed a retrospective IRB-approved study including 92 flatfeet. Three foot and ankle surgeons reviewed patient files and radiographs to classify each foot using both classifications. Bluman classification was performed one time as initially described and a second time after removing the Angle of Gissane sclerosis sign. Interobserver reliabilities were determined with Fleiss' kappa values.
resultsInterobserver reliabilities of Bluman and PCFD classifications were, respectively, substantial 0.67 and moderate 0.55. PCFD Class C and D reliabilities were, respectively, slight 0.07 and fair 0.28. The 276 readings were spread into 10 substages in Bluman and 65 subclasses in PCFD. The progressivity of the Bluman classification prevented the combination of flexible hindfoot valgus (II Bluman, 1A PCFD), midfoot abduction (IIB, 1B) and medial column instability (IIC, 1C) which was frequent in our study (112/276 readings, 40.6%). By removing the Angle of Gissane sclerosis sign from the Bluman classification, the prevalence of stage III decreased from 44.2 to 10.1%.
conclusionsBluman and PCFD classifications were reliable. The PCFD classification showed a larger distribution of different types of flatfeet but Classes C and D need better definition. The progressivity of Bluman classification causes inconsistencies and Gissane angle sclerosis sign is inappropriately used and might lead to incorrect surgical indications.
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