Results of calcaneocuboid distraction arthrodesis

Grunander, Todd R.; Thordarson, David B.

doi:10.1016/j.fas.2011.01.004

Cited by 20 publications

(17 citation statements)

References 21 publications

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“…However, we achieved graft incorporation in 12 of 13 feet (92.31%) after CCDA with synthetic bone grafts. Although the number of subjects was small and the follow-up period short, our results seemed comparable, if not superior, to the cited results (9)(10)(11)(12)(13)(14)(15)(16). We believe that our use of the newly developed rigid b-TCP wedges, which possess a relatively high porosity of 57% and compression strength of 48 MPa, had an important effect on the outcomes.…”

Section: Discussionsupporting

confidence: 71%

“…The incidence of nonunion after CCDA has been reported in 6.25% to 46.87% of cases (9)(10)(11)(12)(13)(14)(15)(16). To the best of our knowledge, Haeseker et al (11) reported the greatest successful fusion rate of 93.75% (15 of 16 feet) after CCDA using autogenous tricortical bone block harvested from the iliac crest.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the greater nonunion rate was explained by the insufficient rigidity of the fixation with a 3-hole one-third tubular plate. Therefore, the use of rigid locking fixation, which prevents or lessens the collapse of the graft, was strongly recommended (12). Conti and Wong (16) also reported a very high rate of nonunion (15 of 32 feet [46.87%]) after CCDA using an autogenous tricortical iliac crest graft.…”

Section: Discussionmentioning

confidence: 99%

“…Although calcaneocuboid distraction arthrodesis (CCDA) has been reported as one of the most effective methods for reconstructing AAFD (8,9), nonunion of the arthrodesis site is a well-known complication of this procedure (9)(10)(11)(12)(13)(14)(15)(16). Historically, tricortical iliac crest autografts and allografts have been chosen as bone graft materials for CCDA, and comparisons of the use of autografts versus allografts have been described in orthopedic studies (14,17).…”

mentioning

confidence: 99%

“…In general, osteotomies will heal more readily than will arthrodeses, in foot and ankle surgery in particular (12). Recent studies have revealed that combinations of rigid plate fixation with some types of hydroxyapatite or b-TCP wedges are useful for supramalleolar osteotomy without fibular osteotomy (mortise-plasty) in treating asymmetric ankle osteoarthritis with varus talar tilt (23,24).…”

mentioning

confidence: 99%

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Calcaneocuboid Distraction Arthrodesis With Synthetic Bone Grafts: Preliminary Results of an Innovative Bone Grafting Procedure in 13 Patients

Kobayashi

Kageyama

Shido

2017

The Journal of Foot and Ankle Surgery

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Calcaneocuboid distraction arthrodesis (CCDA) is regarded as an effective method for reconstructing adult-acquired flatfoot deformity. In the present study, we present our experience with newly developed rigid β-tricalcium phosphate wedges to treat CCDA to better understand the outcomes of this synthetic bone grafting procedure. A total of 13 feet in 13 patients underwent CCDA with synthetic bone grafts. One male (7.69%) and 12 females (92.31%), with a mean age of 65.07 ± 11.83 (range 36 to 77) years, were followed up for a mean duration of 32.76 ± 12.81 (range 18 to 55) months. Successful graft union was postoperatively obtained in 12 of the 13 feet (92.31%). The mean preoperative visual analog scale and American Orthopaedic Foot and Ankle Society scale score were 7.97 ± 1.52 (range 5.4 to 10) and 54.46 ± 14.72 (range 18 to 75), respectively. These scores improved to 1.52 ± 1.78 (range 0 to 6.2) and 85.46 ± 13.38 (range 50 to 97) postoperatively (p = .001 for both comparisons). On radiographic analysis, the talonavicular coverage angle, first metatarsal talar angle, calcaneal pitch, and heel alignment angle had significantly improved (p = .001, p = .028, p = .006, and p = .001, respectively). The use of bone graft substitutes in CCDA is a viable treatment option for reconstructing flexible flatfoot deformity. Although good clinical and radiographic outcomes were obtained, our method is even more challenging than conventional methods and should be used with caution. Rigid locking fixation with a long period of protected weightbearing is highly recommended to attain uneventful bone healing.

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