Lateral Column Lengthening Using a "Z" Osteotomy of the Calcaneus

Griend, Robert Vander

doi:10.1097/btf.0b013e318183a0df

Cited by 43 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4.5, 6.5, or 7.3 cannulated screws were used to secure the osteotomy. If an LCL was performed, the site was accessed through a lateral incision over the anterior calcaneus, and the surgeon utilized either a Griend (step-cut)- or Evans-type osteotomy technique 7,8 . The osteotomy site was packed with autograft and bone marrow aspirate from the iliac crest and anchored with two fully threaded, cortical screws or a claw plate.…”

Section: Methodsmentioning

confidence: 99%

Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity

et al. 2015

View full text Add to dashboard Cite

Background No studies investigating the effect of midfoot (talonavicular joint) position on clinical outcomes following flatfoot reconstruction have been performed. The purpose of our study was to determine whether a postoperative abducted or adducted forefoot alignment, as determined from AP radiographs, was associated with a difference in outcomes using the Foot and Ankle Outcome Score (FAOS). Methods Midfoot abduction was defined on postoperative AP radiographs, evaluated at a mean of 1.9 years in 55 patients from the authors’ institution that underwent flatfoot reconstruction for stage II adult acquired flatfoot deformity (AAFD), as a lateral incongruency angle greater than 5 degrees, a talonavicular uncoverage angle greater than 8 degrees, and a talo-first metatarsal angle greater than 8 degrees based on previously reported measurements. Patients with two or more measurements in the abduction category were classified as the abduction group (n=30); those with one or fewer measurements in the abduction category were placed in the adduction group (n=25). Preoperative FAOS and postoperative FAOS with a mean follow-up of 3.1 years were compared using Wilcoxon rank-sum tests. Results Patients corrected to a position of adduction showed a significantly lower improvement in the FAOS daily activities (p=0.012) and quality of life subscales (p=0.046). Mean improvement in subscale score for the adducted group was lower for pain (p=0.052) and sports activities (p=0.085) but did not reach statistical significance. No significant difference in the FAOS symptoms subscale (p=0.372) between groups was found. Conclusions Correction of the talonavicular joint to a position of adduction following stage II AAFD is associated with decreased patient outcomes in daily activities and quality of life compared with an abducted position. These results suggest that overcorrection to a position of midfoot adduction leads to a lesser amount of individual patient improvement in the reconstruction of stage II AAFD. Level of Evidence Therapeutic Level III

show abstract

Section: Methodsmentioning

confidence: 99%

Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Lateral column lengthening was performed with either a Griend (Stepcut)- or Evans-type osteotomy through a lateral incision over the anterior calcaneus. 8,10 The osteotomy site was then filled with autograft and bone marrow aspirate from the ipsilateral iliac crest and fixed with two fully threaded, cortical screws or a claw plate.…”

Section: Methodsmentioning

confidence: 99%

Optimal Position of the Heel Following Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity

et al. 2015

View full text Add to dashboard Cite

Background While previous work has demonstrated a linear relationship between the amount of medializing calcaneal osteotomy (MCO) and the change in radiographic hindfoot alignment following reconstruction, an ideal postoperative hindfoot alignment has yet to be reported. The aim of this study was to identify an optimal postoperative hindfoot alignment by correlating radiographic alignment with patient outcomes. Methods Fifty-five feet in 55 patients underwent flatfoot reconstruction for stage II AAFD by two fellowship-trained foot and ankle orthopedic surgeons. Hindfoot alignment was determined as previously described by Saltzman and El-Khoury. Changes in pre- and postoperative scores in each FAOS subscale were calculated for patients in postoperative hindfoot valgus (≥0 mm valgus, n=18), mild varus (>0 to 5 mm varus, n=17), and moderate varus (>5 mm varus, n=20). Analysis of variance and post-hoc Tukey’s tests were used to compare the change in FAOS scores between these three groups. Results At 22 months or more postoperatively, patients corrected to mild hindfoot varus showed a significantly greater improvement in the FAOS pain subscale compared to patients in valgus (p=0.04) and symptoms subscale compared to patients in moderate varus (p=0.03). Although mild hindfoot varus did not differ significantly from moderate varus or valgus in the other subscales, mild hindfoot varus did not perform worse than these alignments in any FAOS subscale. No statistically significant correlations between intraoperative MCO slide distances and FAOS subscales were found. Conclusions Our study indicates that correction of hindfoot alignment to between 0 and 5 mm of varus on the hindfoot alignment view (clinically a straight heel) following stage II flatfoot reconstruction was associated with the greatest improvement in clinical outcomes following hindfoot reconstruction in stage II AAFD.

show abstract

“…44 In addition to the Evans and Hintermann osteotomies, there is increasing use of the "Z-type" or "step-cut" lengthening osteotomy. 116 The osteotomy is performed in the anterior calcaneus, with 3 step-cuts made (distal vertical, horizontal, and proximal vertical) to form a Z-shaped pattern. The distal portion can then be rotated and lengthened to create an opening lateral wedge effect.…”

Section: Forefoot Abductionmentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

149

View full text Add to dashboard Cite

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.

show abstract

Lateral Column Lengthening Using a "Z" Osteotomy of the Calcaneus

Cited by 43 publications

References 15 publications

Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity

Correlation of Postoperative Midfoot Position With Outcome Following Reconstruction of the Stage II Adult Acquired Flatfoot Deformity

Optimal Position of the Heel Following Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Contact Info

Product

Resources

About