Contribution of Lateral Column Lengthening to Correction of Forefoot Abduction in Stage IIb Adult Acquired Flatfoot Deformity Reconstruction

Chan, Jeremy; Greenfield, Stephen; Soukup, Dylan S.; Hương, Trần Thu; Deland, Jonathan T.; Ellis, Scott J.

doi:10.1177/1071100715596607

Cited by 64 publications

(59 citation statements)

References 27 publications

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“…54,84 Optimal LCL graft size may be determined by literature-based formulas, in which each additional millimeter of lengthening performed corresponds to a 6.8-degree change in lateral incongruency angle. 22 The amount of graft is typically 4 to 8 mm, the amount required to correct forefoot abduction without losing all eversion.…”

Section: Forefoot Abductionmentioning

confidence: 99%

“…31 In more severe deformities, when forefoot abduction is severe and talonavicular uncoverage exceeds 30%, LCL may be beneficial to achieve the necessary correction. 22,31,67 MCO and LCL can be combined to achieve large amounts of correction. 86,108 Biomechanically, this is advantageous because it provides enhanced deformity correction and reduces lateral foot pressures that may cause pain or other lateral column complications.…”

Section: Forefoot Abductionmentioning

confidence: 99%

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Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

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148

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Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.

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Section: Forefoot Abductionmentioning

confidence: 99%

Section: Forefoot Abductionmentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

Self Cite

148

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“…Lateral column lengthening has been used to deal with flatfoot with prominent forefoot abduction deformity, which is of great significance to the reduction of talonavicular abduction angle [ 13 , 14 ]. A cadaveric experiment performed by Baxter et al showed that LCL procedure could correct 60% hindfoot valgus deformity in addition to 100% midfoot abduction deformity [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Double calcaneal osteotomy for severe adolescent flexible flatfoot reconstruction

Cao

et al. 2017

J Orthop Surg Res

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BackgroundThe timing and strategy of treatment for flatfoot still remain controversial. It is a difficult problem when facing severe adolescent flexible flatfoot because a single procedure cannot realign flatfoot deformity effectively.MethodsWe reviewed 13 adolescent flexible flatfoot patients who underwent double calcaneal osteotomy during May 2012 to June 2015. The mean age of patients was 15.2 ± 1.8 (range, 10–18) years. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) scores and SF-36 score were adopted to evaluate the preoperative and postoperative functions of the foot. Changes of hindfoot valgus angles, talonavicular uncoverage angles on AP view and talo-first metatarsal angles, and talar pitch angles and calcaneal pitch angles on the lateral film before and after surgery were measured.ResultsAll 13 patients (15 ft) were followed. The mean duration of follow-up was 34.5 ± 15.7 (range, 21–60) months. The hindfoot valgus angle improved from 16.5 ± 4.1 to 2.9 ± 1.6. On the foot AP view, the mean preoperative and postoperative talonavicular coverage angles were 24.9 ± 8.5 and 6.5 ± 3.6. On the lateral view of the foot, the average preoperative and postoperative talo-first metatarsal angles were 18.1 ± 5.5 and 4.9 ± 4.4. The mean preoperative and postoperative talar pitch angles were 36.4 ± 4.7 and 24.0 ± 5.6. The AOFAS-AH score improved from 68.9 ± 12.3 preoperatively to 94.6 ± 3.9 postoperatively.ConclusionWith additional procedures, double calcaneal osteotomy was an effective method for severe adolescent flexible flatfoot.

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“…Oh et al [10] found that the talonavicular coverage angle was corrected by approximately 4° with each 2 mm increase in Evans LCL. Chan et al also reported that about 2-3° or 2% of the talonavicular coverage angle was corrected per millimeter of LCL clinically [18]. However, Benthien et al [17] found that the talonavicular coverage angle decreased from 46° to 24° with a 10 mm LCL in the flatfoot model.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

Zhou

Ren

et al. 2017

BioMed Research International

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Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p < .05). Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p = .044) and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p < .05), but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

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Contribution of Lateral Column Lengthening to Correction of Forefoot Abduction in Stage IIb Adult Acquired Flatfoot Deformity Reconstruction

Cited by 64 publications

References 27 publications

Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Double calcaneal osteotomy for severe adolescent flexible flatfoot reconstruction

Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

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