Calcaneal Osteotomies in the Treatment of Progressive Collapsing Foot Deformity. What are the Restrictions for the Holy Grail?

Schlickewei, Carsten; Barg, Alexej

doi:10.1016/j.fcl.2021.05.003

Cited by 3 publications

(3 citation statements)

References 94 publications

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“…Progressive collapsing foot deformity (PCFD), also known as “adult-acquired flatfoot deformity” (AAFFD), is a complex foot deformity consisting of multiple components: (1) peritalar subluxation resulting in foot deviation in various planes (e.g., hindfoot valgus, talar plantarflexion, forefoot supination); (2) abduction deformity at the level of the midfoot; and (3) forefoot varus with the first ray elevated above the fifth metatarsal [ 1 , 2 ]. The etiology is still unclear, but generally involves soft tissue degeneration associated with dysfunction of the tibialis posterior tendon (PTT) [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the medial displacement calcaneal osteotomy on foot biomechanics: a systematic literature review

Mueller,

Frosch,

Barg

et al. 2024

Arch Orthop Trauma Surg

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Introduction Progressive collapsing foot deformity (PCFD), formally known as “adult-acquired flatfoot deformity” (AAFFD), is a complex foot deformity consisting of multiple components. If surgery is required, joint-preserving procedures, such as a medial displacement calcaneal osteotomy (MDCO), are frequently performed. The aim of this systematic review is to provide a summary of the evidence on the impact of MDCO on foot biomechanics. Materials and methods A systematic literature search across two major sources (PubMed and Scopus) without time limitation was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria. Only original research studies reporting on biomechanical changes following a MDCO were included. Exclusion criteria consisted of review articles, case studies, and studies not written in English. 27 studies were included and the methodologic quality graded according to the QUACS scale and the modified Coleman score. Results The 27 included studies consisted of 18 cadaveric, 7 studies based on biomechanical models, and 2 clinical studies. The impact of MDCO on the following five major parameters were assessed: plantar fascia (n = 6), medial longitudinal arch (n = 9), hind- and midfoot joint pressures (n = 10), Achilles tendon (n = 5), and gait pattern parameters (n = 3). The quality of the studies was moderate to good with a pooled mean QUACS score of 65% (range 46–92%) for in-vitro and a pooled mean Coleman score of 58 (range 56–65) points for clinical studies. Conclusion A thorough knowledge of how MDCO impacts foot function is key in properly understanding the postoperative effects of this commonly performed procedure. According to the evidence, MDCO impacts the function of the plantar fascia and Achilles tendon, the integrity of the medial longitudinal arch, hind- and midfoot joint pressures, and consequently specific gait pattern parameters.

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Section: Introductionmentioning

confidence: 99%

Impact of the medial displacement calcaneal osteotomy on foot biomechanics: a systematic literature review

Mueller,

Frosch,

Barg

et al. 2024

Arch Orthop Trauma Surg

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“…17,18,21,22 Surgeries usually include realignment using corrective osteotomies and soft tissue tensioning. 15,23,26 Lateral column lengthening (LCL) is one of the most frequently used osteotomies in PCFD alignment correction. 7,23 The original surgical technique described by Evans (E-LCL) consists of a calcaneal osteotomy that begins 10-14 mm proximal from the calcaneal cuboid joint.…”

Section: Introductionmentioning

confidence: 99%

“…17,18,21,22 Surgeries usually include realignment using corrective osteotomies and soft tissue tensioning. 15,23,26…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Distance Mapping to Identify Safe Zones for Lateral Column Lengthening

Efrima,

Barbero,

Ramalingam

et al. 2023

Foot Ankle Int.

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Background: Evans (E-LCL) and Hintermann LCL (H-LCL) lateral column lengthening osteotomies are standard surgical solutions for flexible, progressive collapsing feet. E-LCL is performed between the anterior and middle facets and endangers specific os calcis subtalar joint (OCST) subtypes without distinct facets. H-LCL is oriented between the posterior and middle facets and should be suitable for all OCSTs. Both osteotomies are associated with increased subtalar osteoarthritis, indicating iatrogenic damage. Distance mapping (DM) enables visualization of the relative distance between 2 articular surfaces represented by color patterns. This study aims to measure the safe zones for LCL using 3-dimensional (3D) models and DM; we hypothesize that it could be measured with high reproducibility. Methods: Two raters categorized 200 feet across 134 patients into OCSTs based on the Bruckner classification. Four angles were measured independently. The proximal and distal extents of the posterior safe zone (PSZ) angles were determined for H-LCL osteotomies; similarly, the proximal and distal extents of the anterior safe zone (ASZ) angles were identified for E-LCL osteotomies. Consequently, the surface available for safe osteotomies were calculated. An interclass correlation was used to assess the agreement between the 2 raters. Additionally, analysis of variance and Mann-Whitney U test were used to compare the safe zones between OCSTs. Results: The mean proximal and distal extents of the PSZ angles were 68 ± 7 and 75 ± 5 degrees from a line parallel to the lateral border of the calcaneus, respectively, and the proximal and distal extent of the ASZ angles were 89 ± 6 and 95 ± 5 degrees, respectively. There were no statistically significant differences between the OCSTs. Two raters measured the angles with good to excellent interrater and intrarater agreement. In 18 cases, we were unable to plan for H-LCL or E-LCL osteotomies. Conclusion: Distance mapping could be used to measure the safe zone, tailor a preoperative plan, and potentially reduce the risk for iatrogenic damage in LCL. 3D models and DM can increase the reliability of preoperative plans in bones with complex 3D structures. Level of Evidence: Level III, retrospective comparative study.

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Pé plano valgo adquirido: Conceitos atuais – “Do pé plano valgo adquirido do adulto à deformidade colapsante progressiva do pé”

Dressler,

Carvalho,

Zambelli

et al. 2024

Rev Bras Ortop (Sao Paulo)

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ResumoO distúrbio clínico tradicionalmente conhecido como pé plano valgo por insuficiência do tendão tibial posterior ou pé plano valgo adquirido do adulto tem sido objeto de diversas publicações nas últimas duas décadas, e entende-se agora que o problema não está no tendão tibial posterior em si, pois o distúrbio pode ocorrer até mesmo sem a lesão desse tendão. Estudos trouxeram novos conceitos e entendimentos que questionaram o olhar sobre o tema, o que culminou na substituição das classificações existentes por uma que fosse mais assertiva e discriminativa dos possíveis padrões de apresentação da deformidade. Além disso, também propôs-se a mudança da nomenclatura para “deformidade colapsante progressiva do pé” (DCPP; progressive collapsing foot deformity, PCFD, em inglês).Quanto ao tratamento cirúrgico, ainda persiste o conceito de abordagem à la carte, com ênfase no realinhamento dos eixos, o que pode ser obtido por meio de osteotomias, artrodeses e equilíbrio de partes moles, que consiste em transposições/reparos tendinosos e reconstrução de estruturas ligamentares, sobretudo do complexo ligamentar deltoide e do ligamento mola.

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Calcaneal Osteotomies in the Treatment of Progressive Collapsing Foot Deformity. What are the Restrictions for the Holy Grail?

Cited by 3 publications

References 94 publications

Impact of the medial displacement calcaneal osteotomy on foot biomechanics: a systematic literature review

Impact of the medial displacement calcaneal osteotomy on foot biomechanics: a systematic literature review

Three-Dimensional Distance Mapping to Identify Safe Zones for Lateral Column Lengthening

Pé plano valgo adquirido: Conceitos atuais – “Do pé plano valgo adquirido do adulto à deformidade colapsante progressiva do pé”

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