Flexor tenodesis procedure in the treatment of lesser toe deformities

Schmidt, Eli; Lalevée, Matthieu; Mansur, Nacime Salomão Barbachan

doi:10.1007/s00402-021-03942-9

Cited by 4 publications

(2 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiplanar weight-bearing CT has already proven its superiority in assessing subtalar joint subluxation [29][30][31][32], and subfibular impingement [16,33]. Adding a weight-bearing CT assessment in our readings may improve the reliability of this class [18,[34][35][36][37][38]. In the original PCFD publication [13], it is also unclear whether the presence of sinus tarsi impingement should be considered as peritalar subluxation (Class D) or midfoot abduction (Class B) sign.…”

Section: Discussionmentioning

confidence: 98%

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Lalevée

Mansur

Lee

et al. 2021

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

Introduction Bluman et al., flatfoot classification is based on posterior tibial tendon (PTT) dysfunction leading to a chronological appearance of several foot deformities. An expert consensus recently proposed a new classification named Progressive Collapsing Foot Deformity (PCFD) in which the focus was shifted to five different independent foot and ankle deformities and their flexibility or rigidity. The aim of this study was to compare Bluman and PCFD classifications. We hypothesize that both classifications will be reliable and that the PCFD classification will allow a larger distribution of the different types of foot deformity. Materials and methodsWe performed a retrospective IRB-approved study including 92 flatfeet. Three foot and ankle surgeons reviewed patient files and radiographs to classify each foot using both classifications. Bluman classification was performed one time as initially described and a second time after removing the Angle of Gissane sclerosis sign. Interobserver reliabilities were determined with Fleiss' kappa values. Results Interobserver reliabilities of Bluman and PCFD classifications were, respectively, substantial 0.67 and moderate 0.55. PCFD Class C and D reliabilities were, respectively, slight 0.07 and fair 0.28. The 276 readings were spread into 10 substages in Bluman and 65 subclasses in PCFD. The progressivity of the Bluman classification prevented the combination of flexible hindfoot valgus (II Bluman, 1A PCFD), midfoot abduction (IIB, 1B) and medial column instability (IIC, 1C) which was frequent in our study (112/276 readings, 40.6%). By removing the Angle of Gissane sclerosis sign from the Bluman classification, the prevalence of stage III decreased from 44.2 to 10.1%. Conclusions Bluman and PCFD classifications were reliable. The PCFD classification showed a larger distribution of different types of flatfeet but Classes C and D need better definition. The progressivity of Bluman classification causes inconsistencies and Gissane angle sclerosis sign is inappropriately used and might lead to incorrect surgical indications.

show abstract

Section: Discussionmentioning

confidence: 98%

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Lalevée

Mansur

Lee

et al. 2021

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Two independent and blinded observers, both fellowship-trained orthopedic foot and ankle surgeons, measured the talus-first metatarsal angle (TFMA) in the sagittal plane of WBCT images, preoperative and postoperatively [ 43 – 47 ]. It was considered positive if it had a plantar vertex (collapse) and negative if it had a dorsal vertex.…”

Section: Methodsmentioning

confidence: 99%

Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study

Ehret

Walt

Chinelati

et al. 2022

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

Introduction Instability/collapse of the medial column has been associated with many conditions, particularly progressive collapsing foot deformity (PCFD), hallux valgus (HV), and midfoot arthritis (MA). Restoration of first ray length and sagittal plane alignment to restore the foot tripod is essential when treating these deformities. This study aimed to assess early results, healing, and complication rate of a distraction dorsal opening plantarflexion wedge allograft first tarsometatarsal joint fusion (LapiCotton Procedure) in patients with collapse/instability of the medial column. Methods In this prospective cohort study, we included PCFD, HV, and MA patients that underwent a LapiCotton procedure. Fusion site healing was defined by > 50% bone bridging in both interfaces between allograft wedge and host bone using weight-bearing computed tomography (WBCT) after 3 months. First ray collapse radiographic correction and minor and major complications (deep dehiscence, deep infection, and reoperation) were assessed. Results A total of 22 patients (22 feet) were included (11 PCFD, 6 MA, and 5 of HV patients). Mean follow-up was 5.9 months (range 3–12) and median allograft size was 8 mm (range 5–19 mm). Bone healing was observed in 91% of cases. Two minor complications (9%, both superficial dehiscence) and one major complication (4.5%, deep infection) were observed. Statistically significant improvement of the sagittal plane talus-first metatarsal angle was observed, with mean improvement of 9.4° (95% CI 6.7–12.1°; p < 0.0001). Conclusion In this prospective cohort study of 22 patients treated with the LapiCotton procedure for medial longitudinal arch collapse/instability, we observed a low complication rate (9% minor, 4.5% major), high healing rate after 3 months (91%), one clinically stable radiographic non-union (4.5%) and one unstable non-union (4.5%) needing reoperation. Our results demonstrate promising initial results for LapiCotton technique in treating collapse of the medial longitudinal arch in patients with PCFD, MA and HV deformities. Long-term results are needed to confirm these promising results. Level of evidence Level II, prospective cohort study.

show abstract

Prevalence and pattern of lateral impingements in the progressive collapsing foot deformity

Lalevée

Mansur

Rojas

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Flexor tenodesis procedure in the treatment of lesser toe deformities

Cited by 4 publications

References 41 publications

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

A comparison between the Bluman et al. and the progressive collapsing foot deformity classifications for flatfeet assessment

Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study

Prevalence and pattern of lateral impingements in the progressive collapsing foot deformity

Contact Info

Product

Resources

About