Lateral column lengthening for adolescent idiopathic pes planovalgus deformity – Systematic review

Kumar, Sanjay; Sonanis, S.V.

doi:10.1016/j.jor.2017.07.013

Cited by 20 publications

(21 citation statements)

References 21 publications

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“… 3 A 2017 review of lateral column lengthening performed on 156 paediatric flat feet (146 for idiopathic pes planus) found that the overall complication rate was 17.5% with a revision rate of 12.3%, most commonly for deformity recurrence. 56 Calcaneal osteotomies also are not without risk, with wound complications quoted as high as 28% and infection rates of 20%; although these have improved since minimally invasive techniques has become more popular. 57 …”

Section: Discussionmentioning

confidence: 99%

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

et al. 2021

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Subtalar arthroereisis has a controversial history and has previously been associated with high failure rates and excessive complications. A database search for outcomes of arthroereisis for the treatment of symptomatic paediatric flexible pes planus provided 24 articles which were included in this review, with a total of 2550 feet operated on. Post-operative patient-reported outcome measures recorded marked improvement. Patient satisfaction was reported as excellent in 79.9%, and poor in 5.3%. All radiological measurements demonstrated improvement towards the normal range following arthroereisis, as did hindfoot valgus, supination, dorsiflexion and Viladot grade. Complications were reported in 7.1% of cases, with a reoperation rate of 3.1%. Arthroereisis as a treatment for symptomatic paediatric flexible pes planus produces favourable outcomes and high patient satisfaction rates with a reasonable risk profile. There is still a great deal of negativity and literature highlighting the complications and failures of arthroereisis, especially for older implants. The biggest flaws in the collective literature are the lack of high-quality prospective studies, a paucity of long-term data and the heterogeneity of utilized outcome measures between studies. Cite this article: EFORT Open Rev 2021;6:118-129. DOI: 10.1302/2058-5241.6.200076

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Section: Discussionmentioning

confidence: 99%

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

et al. 2021

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“…Moraleda et al [ 26 ] also reported good clinical and radiographic results in a series of 21 children (33 feet) with symptomatic flexible flatfoot surgical treatment with a calcaneal lengthening osteotomy. More recently, Kumar and Sonanis [ 27 ] reported a systematic review on lateral column lengthening performed in adolescent pes planovalgus deformity. These authors identified seven studies with 103 patients involving 156 feet and concluded that lateral column lengthening leads to good clinical and radiological outcome with high patient satisfaction and acceptable complication rate.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Severe Idiopathic Flexible Flatfoot by Evans–Mosca Technique in Adolescent Patients: A Long-Term Follow-Up Study

Luna

Maio

Caterini

et al. 2021

Advances in Orthopedics

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Flexible idiopathic flatfoot is very common in growing age and rarely causes pain or disability. Surgery is indicated only in severe symptomatic cases that are resistant to conservative treatment, and numerous surgical procedures have been proposed. Lateral column calcaneal lengthening as described by Evans and modified by Mosca is a widely used surgical technique for the correction of severe symptomatic flexible flatfoot. In the present study, we report the long-term clinical and radiographic results in 14 adolescent patients (mean age: 12.8 years) affected by severe symptomatic flexible flatfoot, surgically treated by Evans–Mosca procedure, for a total of 26 treated feet (12 cases bilateral and 2 unilateral). In all cases, surgery was indicated for the presence of significant symptoms resistant to nonsurgical management. Clinical evaluation was made according to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the Foot and Ankle Disability Index (FADI) Score, and Yoo et al.’s criteria. Radiographic evaluation was made using anteroposterior and lateral weight-bearing radiographs of the feet to evaluate Meary’s angle and Costa–Bertani’s angle and to evaluate possible osteoarthritic changes in the midtarsal joints. At follow-up (mean: 7 years and 7 months), we observed a satisfactory result in all patients. The mean average score of the AOFAS Ankle-Hindfoot Scale improved from 60.03 points to 95.26; the mean FADI score improved from 71.41 to 97.44; and according to Yoo et al.’s criteria, the average clinical outcome score was 10.96. At radiographic examination, nonunion of the calcaneal osteotomy was never observed. Meary’s angle improved from an average preoperative value of 25° to 1.38° at follow-up; Costa–Bertani’s angle improved from an average preoperative value of 154.2° to 130.9° at follow-up. In no case, significant radiographic signs of midtarsal joint arthritis were observed. According to our results, we believe that Evans–Mosca technique is a valid option of surgical treatment for severe idiopathic flexible flatfoot and allows a satisfactory correction of the deformity with a low rate of complications.

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“…It realigns the foot by lengthening the lateral column and allowing further bone growth. Lateral column lengthening in adolescents with pes planovalgus has good radiological and clinical outcomes, with high patient satisfaction [ 7 ]. Graft selection includes autologous iliac bone grafts (AIBG), allografts, and xenografts.…”

Section: Introductionmentioning

confidence: 99%

Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents

Lai

Wang

Chang

et al. 2021

BMC Musculoskelet Disord

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Background Evans calcaneal lengthening osteotomy is used to treat symptomatic flexible flatfoot when conservative treatment fails. Grafts such as autologous iliac bone grafts, allografts, and xenografts are implanted at the osteotomy site to lengthen the lateral column of the hindfoot. This study aimed to present the outcomes of an autologous mid-fibula bone graft used for calcaneal lengthening in symptomatic pes valgus in adolescents. Methods We retrospectively examined 23 ft of 13 adolescents who underwent surgery between July 2014 and January 2018. The radiological and clinical outcomes (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale scores) were assessed during a mean follow-up of 49.7 (range, 30.9–73.4) months. The mean distance of the lengthening site was measured to evaluate graft sinking or collapse. The Goldberg scoring system was used to determine the degree of union at the donor and recipient sites. Results The calcaneal pitch and the anteroposterior and lateral talo-first metatarsal (Meary) angles showed significant correction, from 14.4 to 19.6 (p < 0.001), and from 14.5 to 4.6 (p < 0.001) and 13.5 to 8.5 (p < 0.001), respectively. The mean distance of the lengthening site showed no significant change (p = 0.203), suggesting no graft sinking or postoperative collapse. The lateral distal tibial angle showed no significant difference (p = 0.398), suggesting no postoperative ankle valgus changes. Healing of the recipient and donor sites occurred in 23 and 21 ft, respectively. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scores improved significantly, from 68.0 to 98.5 (p < 0.001). Conclusions Evans calcaneal lengthening using an ipsilateral mid-fibula bone autograft resulted in significant improvement in clinical and radiological outcomes without ankle valgus deformity. Hence, it could be a treatment option for lateral column calcaneal lengthening in adolescents.

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Lateral column lengthening for adolescent idiopathic pes planovalgus deformity – Systematic review

Cited by 20 publications

References 21 publications

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

Surgical Treatment of Severe Idiopathic Flexible Flatfoot by Evans–Mosca Technique in Adolescent Patients: A Long-Term Follow-Up Study

Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents

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