Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity

Moore, Spencer H.; Carstensen, S. Evan; Burrus, M. Tyrrell; T, Cooper; Park, Joseph S.; Perumal, Venkat

doi:10.1177/1938640017735890

Cited by 10 publications

(19 citation statements)

References 44 publications

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“…2,[12][13][14] A small series evaluating radiographic outcomes and complications of metal augmentation for calcaneal lateral column lengthening in flatfoot correction has been reported. 3,5,9,11 Although this study provides an early follow-up period, we hypothesize that a titanium wedge implant will allow bone ingrowth and will provide acceptable structural correction with low complication rates when used for a medial cuneiform opening wedge osteotomy during flatfoot operative correction.…”

mentioning

confidence: 99%

Complications and Early Radiographic Outcomes of Flatfoot Deformity Correction With Metallic Midfoot Opening Wedge Implants

Fraser

Kadakia

Doty

2019

Foot & Ankle Orthopaedics

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Background: Forefoot varus is a common component of flatfoot deformity that is often surgically addressed. Multiple options exist to plantarflex the medial column, with midfoot fusion and the Cotton osteotomy being the most common. This study analyzes radiographic outcomes and complications when a titanium wedge is used for structural support in a dorsal opening wedge Cotton osteotomy of the medial cuneiform. Methods: Between December 2016 and May 2018, 32 feet in 31 patients were treated with medial column titanium wedges for residual forefoot varus in association with flatfoot corrections. All participants had preoperative and weight-bearing postoperative radiographs examined for analysis of radiographic correction. The average age of the patients was 41.1 (range: 12-70). The average follow-up time for patients was 12.2 months (8-24). Results: All radiographic parameters were statistically significantly improved from preoperative to postoperative ( P < .05). There were no instances of nonunion of the medial cuneiform osteotomy. There was 1 implant that loosened and was revised to a larger implant that healed uneventfully. No wedges were removed for continued pain at the osteotomy site. Conclusion: This study suggests that metal wedges are both safe and effective for use in medial column correction based on early follow-up data. Future studies comparing titanium wedges versus traditional bone grafting for Cotton osteotomies may provide further analysis of radiographic correction, operative time, procedure cost, and outcomes. There were no instances of pain over the titanium wedge site. Radiographic outcomes are similar to those reported for opening wedge Cotton osteotomies including bone grafting and wedge plates with screws. Future studies will help determine the long-term maintenance of correction and hardware survivorship. Level of Evidence: Level IV, case series.

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confidence: 99%

Complications and Early Radiographic Outcomes of Flatfoot Deformity Correction With Metallic Midfoot Opening Wedge Implants

Fraser

Kadakia

Doty

2019

Foot & Ankle Orthopaedics

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“…Many techniques of external column lengthening have been described in the treatment of flatfoot, either using the iliac crest bone, peek cage, or titanium Wedges (9) ; and was also fixed with different implants, such as pins, screws, or screwed plates (10) . Any implant in the lengthening region usually causes direct irritation on peroneal tendons, and a high percentage of patients undergo reoperation for the removal of surgical material, due intolerance or tendinous injury (11) .…”

Section: Discussionmentioning

confidence: 99%

External column lengthening with peek cage and modified single approach

et al. 2021

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Objective: To show the results obtained with the treatment of stage 2B flatfoot according to Myerson classification (reducible and flexible), through external column lengthening with interposition of a peek cage filled with spongious graft taken from the same calcaneus, without osteosynthesis, combined with medial slide calcaneal osteotomy with step plate, both using the a single approach. Medial time was associated with latero-lateral transfer of common flexor tendon of toes to posterior tibial. Methods: Sixteen patients were assessed from 2015 to 2018, of which 11 were women and 5 were men. In all cases, surgery was performed with a first lateral time for osteotomies and a second time for tendon repair. Mean patients’ follow-up was 28 months. Results: All patients achieved consolidation of both osteotomies at nearly 12 postoperative weeks. No patient presented signs of peek cage migration due to lack of stability or dorsal cutaneous nerve branch injuries resulting from this modified single approach. Two patients evolved with wound dehiscence and only one with calcaneocuboid pain so far. No patient required reoperation. Conclusion: The modified single tuberosity approach for the two osteotomies has shown to be a simple procedure that prevents damages to dorsal cutaneous nerve branches described with dorsal approach. Leve lof Evidence IV; Therapeutic Studies; Case Series.

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“…Die Verlängerung der lateralen Säule geschieht üblicherweise durch Osteotomie des anterioren Kalkaneus (Operation nach Evans, Lateral Column Lengthening; LCL) 51 . Moore et al konnten mit dieser Technik unter Verwendung von porösen Titan-Wedges in Kombination mit anderen knöchernen und Weichteiloperationen bei 30 Stadium-II-Plattfußpatienten gute klinisch-radiologische Ergebnisse erzielen 52 .…”

Section: Chirurgische Therapie Der Flexiblen Fehlstellungunclassified

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Döring¹,

Vertesich²,

Puchner³

2021

Z Orthop Unfall

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ZusammenfassungDer erworbene Plattfuß des Erwachsenen präsentiert sich als langsam progrediente Deformität, die unbehandelt zu quälenden Schmerzen und Einschränkungen der Aktivitäten des täglichen Lebens führen kann. Die Therapiemaßnahmen sind vielfältig und abhängig von klinischer und radiologischer Präsentation, sodass für jeden Patienten eine individuelle Versorgung geplant werden muss. Dieser Beitrag spannt einen Bogen von der Ätiopathogenese über die chirurgische Therapie bis hin zur postoperativen Mobilisierung und Rehabilitation.

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Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity

Abstract: Level IV: Case series.

Cited by 10 publications

References 44 publications

Complications and Early Radiographic Outcomes of Flatfoot Deformity Correction With Metallic Midfoot Opening Wedge Implants

Complications and Early Radiographic Outcomes of Flatfoot Deformity Correction With Metallic Midfoot Opening Wedge Implants

External column lengthening with peek cage and modified single approach

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

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