Flatfoot deformity represents a complex pathology often observed in active adult population. Conservative treatment does not always yield the intended outcome. Various surgical methods addressing mentioned pathology were actively developing during past decades. However, despite diversity of procedures there are many contradictions in respect of necessity and efficiency of a certain procedure especially in grades II and IV of the disease. The paper presents clinical, roentgenological and biomechanical features of acquired flatfoot deformity. The authors analyzed literature publications dedicated to different correction methods adopted in world orthopaedics.
Purpose of the study - to validate the selection algorithm of surgical treatment for patients with advance stage of ankle joint deforming arthrosis based on comparative analysis of risk factors for failed cases of fusion and joint replacements. Material and methods. The authors analyzed poor treatment outcomes and reasons therefore after ankle joints fusion and replacement surgeries performed at Vreden Russian Research Institute of Traumatology and Orthopaedics starting 2003 till 2014. First study group included 63 patients who underwent biarticular fusion of ankle and subtalar joint by intramedullary locked nail; second study group included 71 patients after ankle joint replacement using the following implants: Mobility (DePuy) - 27 patients, Hintegra (NewDeal) - 37 and STAR (Waldemar Link) - 7 patients accordingly. Clinical and radiological examination of patients as well as their surveying on pain rating scale and AOFAS scale was carried out in the period starting 6 months to 10 years from surgery. Results. Study results proved that severe deformities of ankle joint bones particularly varus or valgus deformities with angle above 100 preclude the possibility to correctly position the implant components and do not promise long term and successful functional recovery. Thus, fusion of affected joint should be recommended as treatment option to patients with abovementioned heavy deformities of angle joint. Reasonable fusion angles for ankle joint around 90950 in sagittal plane could diminish potential rapid arthrosis progression in midfoot joints. Conclusion. In view of identified risk factors for development of morbid conditions that account for poor surgical outcomes of ankle joint fusion and replacement, basing on own research results and specialized literature data the authors have validated and presented the selection algorithm of surgical treatment options for patients with end stage of deforming arthrosis
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.