Lateral Column Lengthening Corrects Hindfoot Valgus in a Cadaveric Flatfoot Model

Baxter, Josh R.; Demetracopoulos, Constantine A.; Prado, Marcelo Pires; Tharmviboonsri, Theerawoot; Deland, Jonathan T.

doi:10.1177/1071100715571439

Cited by 30 publications

(20 citation statements)

References 18 publications

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“…All the patients and their parents were satisfied with the functional outcomes (Table 1 Some authors previously observed that LCL or double calcaneal osteotomy was optimal for severe forefoot abduction deformity and also better realigned the midfoot transverse plane deformities [5,9,17]. A cadaveric study also reported that LCL can restore 60% of hindfoot valgus deformities associated with 100% forefoot abduction deformity [18]. In the current study, there were 16 feet that underwent LCL and 13 feet that underwent double calcaneal osteotomy.…”

Section: Resultssupporting

confidence: 53%

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

Wen

Nie

Cheng

et al. 2020

Preprint

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Background: The indications for surgery, timing, and procedure in children with flexible flatfoot deformity remain controversial. For marked deformities, combined procedures are preferred to correct multiple plane deformities. Thus, this study aimed to evaluate the outcomes of osteotomies combined with soft tissue procedures in children with flexible flatfoot aged 9-14 years.Methods: From July 2014 to October 2017, 28 children (47 feet) with flexible flatfoot with an average age of 11.7±2.1 (range 9-14) years underwent osteotomy combined with soft tissue surgery. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Foot and Ankle Outcome Score (FAOS) were used to evaluate the preoperative and postoperative clinical outcomes. The talo-navicular coverage angle (TNCA) and talar–first metatarsal angle (T1MA) on the foot anteroposterior view, calcaneal pitch angle and Meary’s angle on the foot lateral view, and calcaneus valgus angle (CVA) on the Saltzman view were also observed.Results: All patients were followed up for an average duration of 29.7±8.6 months. Mean AOFAS and FAOS significantly improved from 56.6±8.0 and 47.4±9.5 preoperatively to 88.4±3.9 and 83.2±6.8 at final follow-up (P<0.001). respectively. There were statistically significant differences between preoperative and postoperative scores in all FAOS subscales (P<0.001). Radiographic parameters, such as TNCA (P<0.001) and T1MT (P<0.001) on foot AP views, calcaneal pitch angle (P=0.014) and Meary,s angle (P<0.001) on foot lateral views, and CVA (P<0.001) on Saltzman views, were significantly improved. All patients and their parents were satisfied with the functional outcomes.Conclusion: Osteotomies combined with soft tissue procedures are an effective strategy for flexible flatfoot deformity in children, as it results in favorable radiographic and functional outcomes.

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Section: Resultssupporting

confidence: 53%

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

Wen

Nie

Cheng

et al. 2020

Preprint

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“…In other cadaveric studies of ankle biomechanics, fresh specimens were often fixed on an experimental frame or to a test bench with a Kirschner wire 10 20 21 22 . However, even if a person stands still, the foot joints slide and rotate slightly to balance the body’s weight 23 .…”

Section: Discussionmentioning

confidence: 99%

Effects of five hindfoot arthrodeses on foot and ankle motion: Measurements in cadaver specimens

Zhang

Chen

Qiang

et al. 2016

Sci Rep

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Single, double, and triple hindfoot arthrodeses are used to correct hindfoot deformities and relieve chronic pain. However, joint fusion may lead to dysfunction in adjacent articular surfaces. We compared range of motion in adjacent joints before and after arthrodesis to determine the effects of each procedure on joint motion. The theory of moment of couple, bending moment and balanced loading was applied to each of 16 fresh cadaver feet to induce dorsiflexion, plantarflexion, internal rotation, external rotation, inversion, and eversion. Range of motion was measured with a 3-axis coordinate measuring machine in a control foot and in feet after subtalar, talonavicular, calcaneocuboid, double, or triple arthrodesis. All arthrodeses restricted mainly internal-external rotation and inversion-eversion. The restriction in a double arthrodesis was more than that in a single arthrodesis, but that in a calcaneocuboid arthrodesis was relatively low. After triple arthrodeses, the restriction on dorsiflexion and plantarflexion movements was substantial, and internal-external rotation and inversion-eversion were almost lost. Considering that different arthrodesis procedures cause complex, three-dimensional hindfoot motion reductions, we recommend talonavicular or calcaneocuboid arthrodesis for patients with well-preserved functions of plantarflexion/dorsiflexion before operation, subtalar or calcaneocuboid arthrodesis for patients with well-preserved abduction/adduction, and talonavicular arthrodesis for patients with well-preserved eversion/inversion.

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“…This foot position was prescribed using an aluminum wedge with a 10°slope. The 12 test conditions were loaded based on a previously described loading regime [3,20]: a 400-N ground reaction force was achieved and maintained from an axial load applied along the axis of the tibia and a 350-N tensile load along the Achilles tendon through a pneumatic cylinder (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Hutchinson

Baxter

Gilbert

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background While successful subtalar joint arthrodesis provides pain relief, resultant alterations in ankle biomechanics need to be considered, as this procedure may predispose the remaining hindfoot and tibiotalar joint to accelerated degenerative changes. However, the biomechanical consequences of isolated subtalar joint arthrodesis and additive fusions of the Chopart's joints on tibiotalar joint biomechanics remain poorly understood. Questions/purposes We asked: What is the effect of isolated subtalar fusion and sequential Chopart's joint fusions of the talonavicular and calcaneocuboid joints on tibiotalar joint (1) mechanics and (2) kinematics during loading for neutral, inverted, and everted orientations of the foot? Methods We evaluated the total force, contact area, and the magnitude and distribution of the contact stress on the articular surface of the talar dome, while simultaneously tracking the position of the talus relative to the tibia during loading in seven fresh-frozen cadaver feet. Each foot was loaded in the unfused, intact control condition followed by three randomized simulated hindfoot arthrodesis modalities: subtalar, double (subtalar and talonavicular), and triple (subtalar, talonavicular, and calcaneocuboid) arthrodesis. The intact and arthrodesis conditions were tested in three alignments using a metallic wedge insert: neutral (flat), 10°i nverted, and 10°everted. Results Tibiotalar mechanics (total force and contact area) and kinematics (external rotation) differed owing to hindfoot arthrodeses. After subtalar arthrodesis, there were Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® decreases in total force (445 ± 142 N, 95% CI, 340-550 N, versus 588 ± 118 N, 95% CI, 500-676 N; p \ 0.001) and contact area (282 mm 2 , 95% CI, 222-342 mm 2 , versus 336 ± 96 mm 2 , 95% CI, 265-407 mm 2 ; p \ 0.026) detected during loading in the neutral position; these changes also were seen in the everted foot position. Hindfoot arthrodesis also was associated with increased external rotation of the tibiotalar joint during loading: subtalar arthrodesis in the neutral loading position (3.3°± 1.6°; 95% CI, 2°-4.6°; p = 0.004) and everted loading position (4.8°± 2.6°; 95% CI, 2.7°-6.8°; p = 0.043); double arthrodesis in neutral (4.4°± 2°; 95% CI, 2.8°-6°; p = 0.003) and inverted positions (5.8°± 2.6°; 95% CI, 3.7°-7.9°; p = 0.002), and triple arthrodesis in all loaded orientations including neutral (4.5°±1.8°; 95% CI, 3.1°-5.9°; p = 0.002), inverted (6.4°± 3.5°; 95% CI, 3.6°-9.2°; p = 0.009), and everted (3.6°± 2°; 95% CI, 2°-5.2°; p = 0.053) positions. Finally, after subtalar arthrodesis, additive fusions at Chopart's joints did not appear to result in additional observe...

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Lateral Column Lengthening Corrects Hindfoot Valgus in a Cadaveric Flatfoot Model

Abstract: Understanding the relative contribution of each operative procedure to the overall deformity correction in flatfoot reconstruction will allow surgeons to accurately correct the foot into a plantigrade position while minimizing the risk of overcorrection.

Cited by 30 publications

References 18 publications

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

Effects of five hindfoot arthrodeses on foot and ankle motion: Measurements in cadaver specimens

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

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