Medial Column Instability in Flatfoot Deformity

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I just reread the thread – Columnar Theory of Foot Function 2007. At that time, when I presented my research on Medial Column Supinatus, I felt like I entered an angry hornet´s nest.

In 2002 I published a paper discussing 2 genetic foot deformations previously unrecognized: Primus Metatarsus Supinatus (aka Rothbarts foot) and the PreClinical Clubfoot Deformity. Based on embryological studies, I presented the concept of Medial Column Supinatus and stated:

• Medial column supinatus as the hallmark structural aberration present in Rothbarts foot and the PreClinical Clubfoot Deformity.
• And that medial column supinatus forces the foot to abnormally pronate (flatten). I termed this abnormal pronation - Gravity Drive Pronation

At that time (2002), the existence of medial column supinatus was controversial.

In 2021, the existence of medial column supinatus was confirmed via a cadaver study by Dibbern et al and reconfirmed via WBCT analysis by Schmidt et al.

In 2023 two podiatrists Scott Schleuner and Alan Catanzariti published a paper in Clinics in Podiatric Medicine entitled Addressing Medial Column Instability (Supinatus) in Flatfoot Deformity. They found that the medial column deformation caused the foot to flatten.

Kevin Kirby, Craig Payne or Simon Spooner, do you have any current comments on the structural deformation referred to as Medial Column Instability (Supinatus)?

I have sent invitations to Kirby, Payne and Spooner via the Researchgate message forum to participate in this discussion.

• Schleuner S, Catanzariti A 2023. Addressing Medial Column Instability in Flatfoot Deformity. Clinical Podiatric Medicine and Surgery. Volumne 40, Issue 2, P271-191. April.
• Dibbern K., Briggs H., Behrens A., McGettigan L., Carvalho K., Mansur N., Lalevee M., Netto C. 2021. Reliability of coronal plane rotation measurements in the medial column of the foot: a cadaveric study. Journal Foot and Ankle, December. (DOI: https://doi.org/10.30795/jfootankle.2021.v15.1598)
• Schmidt E., Baumfeld D., Silva T. et al 2021. The Rotational Positioning of the Bones in the Medial Column of the Foot. A Weightbearing CT Analysis. Iowa Orthopaedic Journal. Volume 41, Issue 1. pp 103-109 (https://www.researchgate.net/publication/354765793)

 

Correction. In was in 2020 that the existence of medial column supinatus was first confirmed via WBCT.

Silva TA, Baumfeld DS, et al. 2020. Understanding the Rotational Positioning of the Bones in the Medial Column of the Foot: A Weightbearing CT Analysis. Foot & Ankle Orthopaedics 5(4), Conference AOFAS.