Evaluation of Clinical and Radiological Results of Calcaneal Lengthening Osteotomy in Pediatric Idiopathic Flexible Flatfoot | ||
The Archives of Bone and Joint Surgery | ||
مقاله 11، دوره 6، شماره 5، آذر 2018، صفحه 402-411 اصل مقاله (3.16 M) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2018.26300.1695 | ||
نویسندگان | ||
Taghi Baghdadi1؛ Hamed Mazoochy* 1؛ Mohammad Reza Guiti1؛ Nima Heidari khabbaz2 | ||
1Tehran University of Medical Science, Tehran, Iran | ||
2The Royal London Limb Reconstruction Service St Bartholomew’s and Royal London Hospital Barts Health NHS Trust, London, UK | ||
چکیده | ||
Background: Flexible idiopathic flatfoot is the most common form of flatfoot. First line treatments are parental reassurance and conservative measures; however, surgical treatment may be needed in some cases. A number of surgical techniques with varying results have been described in the literature. Here, we present our clinical and radiological outcomes of calcaneal lengthening osteotomy for pediatric idiopathic flexible flatfoot. Methods: Calcaneal lengthening osteotomy was performed in 20 patients, 30 feet, with idiopathic flexible flatfoot that were resistant to conservative treatment between 2007 and 2011. Patients were evaluated according to ACFAS universal evaluation scoring scale and radiographic indexes. The mean follow up duration was 23.1 ± 9.9 months. Results: The average age was 10.4 ± 0.9 years. Achilles tendon lengthening was performed in 28 feet. ACFAS score at the final follow up had improved significantly compared to pre-operative score (37 to 88, P<0.0001). Radiographic parameters also showed significant improvement after surgery ((P<0.0001)). Distal segment displacement and hardware irritation as postop complications were observed in 2 and 3 cases, respectively, with no long-term clinical impact. Conclusion: Calcaneal lengthening osteotomy is an appropriate and safe operation in symptomatic idiopathic flexible flat foot that is resistant to conservative treatment. Level of evidence: IV | ||
کلیدواژهها | ||
Flat foot؛ Idiopathic؛ Pediatric؛ Radiograph؛ Surgery | ||
مراجع | ||
1. Pfeiffer M, Kotz R, Ledi T, Hauser G, Sluga M. Prevalence of flat foot in preschool aged children. Pediatrics. 2006; 118(2):634-9. 2. Mosca VS. Flexible flatfoot in children and adolescents. J Child Orthop. 2010; 4(2):107-21. 3. Harris EJ, Vanore JV, Thomas JL, Kravitz SR, Mendelson SA, Mendicino RW, et al. Clinical practice guideline: diagnosis and treatment of pediatric flatfoot. J Foot An-kle Surg. 2004; 43(6):341-73. 4. Blitz NM, Stabile RJ, Giorgini RJ, DiDomenico LA. Flexible pediatric and adoles-cent pes planovalgus: conservative and surgical treatment options. Clin Podiatr Med Surg. 2010; 27(1):59-77. 5. Evans AM. The flat-footed child -- to treat or not to treat: what is the clinician to do? J Am Podiatr Med Assoc. 2008; 98(5):386-93. 6. Yeagerman SE, Cross MB, Positano R, Doyle SM. Evaluation and treatment of sympromatic pes planus. Curr Opin Pediatr. 2011; 23(1):262-7. 7. Kwon JY, Myerson MS. Management of the fexible flat foot in the child: a focus on the use of osteotomies for correction. Foot Ankle Clin. 2010; 15(2):309-22. 8. Giannini S, Ceccarelli F, Benedetti MG, Catani F, Faldini C. Surgical treatment of flexible flatfoot in children. J Bone Joint Surg. 2001; 83(2):73-9. 9. Mosca VS. Calcaneal lengthening for valgus deformity of the hindfoot. Results in children who had severe, symptomatic flatfoot and skewfoot. J Bone Joint Surg Am. 1995; 77(4):500-12. 10. Zeifang F, Breusch SJ, Doderlein L. Evans calcaneal lengthening procedure for spastic flexible flat foot in 32 patients (46 feet) with a follow up of 3 to 9 years. Foot Ankle Int. 2006; 27(7):500-7. 11. Andreacchio A, Orellana C, Miller R, Bowen TR. Lateral column lengthening as treatment for planovalgus foot deformity in ambulatory children with spastic cerebral palsy. J Pediatr Orthop. 2000; 20(4):501-5. 12. Yoo WJ, Chung CY, Choi IH, Cho TJ, Kim DH. Calcaneal lengthening for the pesplanovalgus foot deformity in children with cerebral palsy. J Pediatr Orthop. 2005; 25(6):781-5. 13. Ragab A, Stewart SL, Cooperman DR. Implications of subtalar joint anatomic variation in calcaneal lengthening osteotomy. J Pediatr Orthop. 2003; 23(1):79-83. 14. Thomas RL, Wells BC, Garriosr RL, Prada SA. Preliminary results comparing two methods of lateral column lengthening. Foot Ankle Int. 2001; 22(2):107- 19. 15. Hyer C, Lee T, Block A, VanCourt R. Evaluation of anterior and middle talocal-caneal articular facets and the Evans osteotomy. J Foot Ankle Surg. 2002; 41(6):389-93. 16. Bussewitz BW, DeVries JG, Hyer CF. Evans osteotomy and risk to subtalar joint articular facets and sustentaculum tali: a cadaver study. J Foot Ankle Surg. 2013; 52(5):594-7. 17. Cooper PS, Nowak MD, Shaer J. Calcaneocuboid joint pressures with lateral column lengthening (Evans) procedure. Foot Ankle Int. 1997; 18(4):199-205. 18. Shibuya N, Agarwal MR. Evans calcaneal osteotomy using an anterior lumbar distractor-inserter. J Foot Ankle Surg. 2010; 49(4):401-3. 19. Grier KM, Walling AK. The use of tricotical autograft versus allograft in lateral lengthening for adult acquired flat foot deformity and analysis of union rates and complications. Foot Ankle Int. 2010; 31(9):760-9. 20. John S, Child B, Hix G, Maskill M, Bowers C, Catanzariti AR, et al. A retrospec-tive analysis of anterior calcaneal osteotomy with allogenic bone graft. J Foot Ankle Surg. 2010; 49(4):375-9. 21. Bruyn J, Cerniglia M, Chaney M. Combination of Evans calcaneal osteotomy and STA-Peg arthroreisis for correction of the severe pes valgo planus deformity. J Foot Ankle Surg. 1999; 38(5):339-46. 22. Dayton P, Prins DB, Smith DE, Feilmeier MJ. Effectiveness of a locking plate in preserving midcalcaneal length and positional outcome after Evans calcaneal oste-otomy: a retrospective pilot study. J Foot Ankle Surg. 2013; 52(6):710-3. 23. Hintermann B, Valderrabano V, Kundert HP. Lengthening of the lateral col-umn and reconstruction of the medial soft tissue for treatment of acquired flat foot deformity associated with insufficiency of posterior tibial tendon. Foot Ankle Int. 1999; 20(10):622-9. 24. Viegas GV. Reconstruction of pediatric flexible planovalgus foot by using an Evans calcaneal osteotomy and augmentative medial split tibialis anterior tendon transfer. J Foot Ankle Surg. 2003; 42(4):199-207. 25. Evans D. Calcaneo-valgus deformity. J Bone Joint Surg Br. 1975; 57(3):270-8. 26. Phillips GE. A review of elongation of os calcis for flat feet. J Bone Joint Surg Br. 1983; 65(1):15-8. 27. Dogan A, Albayrak M, Akman E, Zorer G. The result of calcaneal lengthening ostetomy for the treatment of flexible pes planovalgus and evaluation of alignment of the foot. Acta Orthop Traumatol Turc. 2006; 40(5):356-66. 28. Mousavian A, Orapin J, Chinanuvathana A, Schon LC. Anatomic spring ligament and posterior tibial tendon reconstruction: new concept of double bundle PTT and a novel technique for spring ligament. Arch Bone Jt Surg. 2017; 5(3):201-5. 29. Weinraub GM, Dault R. The Evans osteotomy: technique and fixation with cor-tical bone pin. J Foot Ankle Surg. 2001; 40(1):54-7. 30. Templin D, Jones K, Weiner DS. The incorporation of allogeneic and autoge-nous bone graft in healing of lateral column lengthening of the calcaneus. J Foot Ankle Surg. 2008; 47(4):283-7. 31. Adams SB Jr, Simpson AW, Pugh LI, Stasikelis PJ. Calcaneocubiod joint sublux-ation after calcaneal lengthening for planovalgus foot deformity in children with cerebral palsy. J Pediatr Orthop. 2009; 29(2):170-4. 32. Dunn SP, Meyer J. Displacement of the anterior process of the calcaneus after Evans calcaneal osteotomy. J Foot Ankle Surg. 2011; 50(4):402-6. 33. Bourdet C, Seringe R, Adamsbaum C, Glorion C, Wicart P. Flatfoot in children and adolescents. Analysis of imaging findings and therapeutic implications. Orthop Traumatol Surg Res. 2013; 99(1):80-7. 34. Reilingh ML, Beimers L, Tuijthof GJ, Stufkens SA, Maas M, van Dijk CN. Measur-ing hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view. Skeletal Radiol. 2010; 39(11):1103-8. | ||
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