Functional Activity After Flatfoot Reconstruction With Lateral Column Lengthening

Abstract

Background The objective of this study was to evaluate return to activity following flatfoot reconstruction with lateral column lengthening (LCL) by assessing functional postoperative data and identifying patient characteristics associated with poor function following surgery. Methods Consecutive patients that underwent operative flatfoot correction including LCL and other necessary procedures from 2014 to 2019 by 3 fellowship trained foot and ankle orthopedic surgeons were retrospectively administered Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and FAAM Sports questionnaires with no preoperative scoring available. Patient demographic factors, comorbidities, and radiographic features were evaluated as predictors of outcome scores to simulate return to activity. Statistical analysis, including student’s t-tests and analysis of variance, was performed. Results A total of 54 patients were included. A body mass index (BMI) of 30 kg/m2 or greater was associated with a lower ADL score (P = .002) and Sports score (P = .002). Preoperative hindfoot valgus of 9° or higher was associated with higher ADL scores (P = .040). Neither age nor any flatfoot radiographic parameters yielded significant differences in functional scores. Conclusion This study demonstrated relatively high average FAAM scores in both the ADL and the sports subscales, consistent with previous studies. This study also identified lower BMI and greater preoperative hindfoot valgus as potential predictors of improved functional outcome following reconstruction. Level of Evidence: Level III: Retrospective case control

Isolated Talonavicular Arthrodesis as Treatment for Flexible Progressive Collapsing Foot Deformity: A Case Series

“…Prior studies using FAAM scores to assess outcomes of flatfoot deformity correction have shown promising results with a variety of techniques. 2 , 8 , 14 , 17 , 19 In general, preoperatively our patients had poorer scores. Our preoperative FAAM ADL and sports score were 53.9 and 29.7, respectively.…”

Outcomes and Complications Associated with Lateral Column Lengthening Using Porous Titanium Wedges for Flexible Flatfoot Deformity Correction: A Systematic Review

“…Four of seven studies reported no fixation for LCL titanium wedge stabilization [15][16][17][18]. Two studies utilized one or two 2.4 mm cortical screws for titanium wedge stabilization in all patients [19,20].…”

“…Another study discussed the placement of a lateral plate in conjunction with the LCL titanium wedge but did not discuss the number of patients or indications for this additional fixation [8]. The size of the graft(s) utilized was reported in 6 of 7 of the included studies [8,[15][16][17][18][19] though two studies [15,16] reported a range of the graft size used, not individualized for each patient. Stamatos, et al did not report the graft size used [20].…”

“…All publications with greater than 1-year follow-up, including LCLs performed with PTWs, were included in the systematic review. The the titanium wedge ranged from 4.5-12 mm with 8 mm being the most commonly reported graft size used (60 patients) [8,[15][16][17][18][19][20].…”

“…Outcome measures were reported in three of the included studies [15][16][17]. The Foot and Ankle Ability Measure (FAAM) was reported in 99 patients and the Visual Analog Scale (VAS) pain score was reported in 71 patients.…”