Radiological evaluation and comparison between standard and hindfoot alignment parameters in Adult Acquired Flatfoot Deformity in Indian population

The study aimed to assess the hindfoot alignment in Adult-Acquired Flatfoot Deformity (AAFD) patients using weight-bearing radiographs and traditional flatfoot parameters in Indian population. The study compared the results with established flatfoot parameters. Analysis of 94 weight-bearing ankle and foot radiographs of patients with AAFD, on eleven parameters; Meary’s angle, Calcaneal pitch angle, lateral talocalcaneal angle, medial column height, lateral column height, Talo-navicular coverage angle, 1st metatarsal talar angle, Calcaneo-fifth metatarsal angle, Calcaneal offset index, Hindfoot alignment angle, and Hindfoot moment arm. The correlation between these parameters was calculated using Karl Pearson correlation analysis. Inter-observer and intra-observer reliability were calculated. Meary’s angle had an excellent correlation with the hindfoot alignment angle (r = 0.331, p 0.001) and a good correlation with the hindfoot moment arm (r = 0.304, p 0.003). The hindfoot moment arm showed a good correlation with the hindfoot alignment angle (r = 0.300 p 0.003) and calcaneal offset index (r = 0.316 p 0.002). Interobserver and intra-observer reliability for all radiographic measurements was good to excellent. The hindfoot alignment angle, hindfoot moment arm are effective in assessing hindfoot alignment and guiding treatment recommendations. The inclusion of these radiographic parameters in diagnostic criteria can enhance evaluation precision and patient outcomes in AAFD management, aiding in pre-intervention and post-intervention assessment.