Medial Double Arthrodesis With Lateral Column Sparing and Arthrodiastasis: A Radiographic and Medical Record Review

Berlet, Gregory C.; Hyer, Christopher F.; Scott, Ryan T.; Galli, Melissa M.

doi:10.1053/j.jfas.2014.10.012

Cited by 20 publications

(18 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In patients whose calcaneocuboid joints are not involved in their primary disease, a double arthrodesis still provides improvement in pain, function, satisfaction, cosmesis, and shoewear. 15,102 Unfortunately, even in a double arthrodesis, patients still are at increased risk for adjacent joint (ankle, midfoot, calcaneocuboid) arthritis. 102 In addition, if there is severe hindfoot valgus, an MCO can be performed in conjunction with a double or triple arthrodesis.…”

Section: Double/triple Arthrodesismentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

142

View full text Add to dashboard Cite

Adult-acquired flatfoot deformity (AAFD) comprises a wide spectrum of ligament and tendon failure that may result in significant deformity and disability. It is often associated with posterior tibial tendon deficiency (PTTD), which has been linked to multiple demographic factors, medical comorbidities, and genetic processes. AAFD is classified using stages I through IV. Nonoperative treatment modalities should always be attempted first and often provide resolution in stages I and II. Stage II, consisting of a wide range of flexible deformities, is typically treated operatively with a combination of soft tissue procedures and osteotomies. Stage III, which is characterized by a rigid flatfoot, typically warrants triple arthrodesis. Stage IV, where the flatfoot deformity involves the ankle joint, is treated with ankle arthrodesis or ankle arthroplasty with or without deltoid ligament reconstruction along with procedures to restore alignment of the foot. There is limited evidence as to the optimal procedure; thus, the surgical indications and techniques continue to be researched.

show abstract

Section: Double/triple Arthrodesismentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

142

View full text Add to dashboard Cite

show abstract

“…If transfer of the flexor digitorum longus was required, this was performed after fixation of the osteotomy. 1…”

Section: Methodsmentioning

confidence: 99%

Outcomes of the Extended Z-Cut Osteotomy for Correction of Adult Acquired Flatfoot Deformity

Ebaugh

Larson²,

Reb

et al. 2019

Foot Ankle Int.

Self Cite

View full text Add to dashboard Cite

Background: Medial displacement calcaneus tuberosity osteotomy and anterior process lengthening calcaneus osteotomy are traditional single-plane osteotomy techniques used in adult acquired flatfoot deformity reconstruction. More recently, 3-plane step-cut osteotomies were described for each of these and shown to offer improved rotational stability via the horizontal limb. However, a major technical challenge is achieving a sufficiently long horizontal limb to correct deformity through lengthening without losing bony apposition. Combining the anterior process and tuberosity step-cuts using an elongated horizontal limb alleviates this technical challenge, creates a very large surface area for bony healing, and utilizes a single incision. We hypothesized that the Z-cut osteotomy would achieve clinical and radiographic flatfoot deformity correction with a high union rate. Methods: This was an institutional review board-approved retrospective study of 16 patients who underwent Z-cut osteotomy for the treatment of moderate to severe symptomatic adult acquired flatfoot deformity, stage IIA/B. The mean radiographic follow-up was 8.8 months, while the mean clinical follow-up was 2.36 years. Radiographic correction was assessed via weightbearing radiographs taken preoperatively and at a mean of 26 ± 2 weeks postoperatively. Measurements included Meary’s angle (talo–first metatarsal angle), talonavicular (TN) joint uncoverage percentage, TN incongruency angle, medial cuneiform to fifth metatarsal height, and calcaneal pitch. Union rates and clinical outcomes via the Foot Function Index (FFI) score were assessed preoperatively and at a mean of 29 months following surgery. Paired t test was used to compare both clinical and radiographic outcomes with statistical significance set at P < .05. Results: Fifteen of 16 patients returned an FFI questionnaire with a mean improvement of 52.1 to 10.3 ( P = .002). The calcaneal pitch improved from 12.7 to 15.2 degrees ( P = .002), the medial cuneiform–fifth metatarsal distance improved from 12.8 to 18.5 mm ( P = .002), the TN coverage angle improved from 21.3 to 9.1 degrees ( P < .001), the TN uncoverage percentage improved from 32.9% to 20.3% ( P < .001), and the TN incongruency angle improved from 41.4 to 19.9 degrees ( P < .001). Deformity correction was well maintained in 13 of 16 patients at final follow-up. The union rate of the osteotomy was 100%. Three patients had symptomatic hardware initially; 1 patient required removal of hardware. One patient developed a superficial infection that cleared. Another patient developed peroneal tendonitis, which resolved with corticosteroid injection. Conclusion: The Z-cut osteotomy is a novel, technically simplified, single-incision, single-osteotomy alternative to the previously described double calcaneus osteotomy techniques for reconstructing flexible moderate to severe adult acquired flatfoot deformity that offers comparable short-term clinical and radiographic outcomes with acceptably low complications. Level of Evidence: Level IV, retrospective case series.

show abstract

“…Ermöglicht wird die Reduktion auf eine Double-Arthrodese durch eine Dekompression und Distraktion des CC-Gelenks, welche mit einer Arthrodese des ST- und TN-Gelenks und entsprechender Abduktionskorrektur erfolgt. Als Vorteile der Double-Arthrodese gelten hierbei eine Erhöhung der Restbeweglichkeit durch Gelenkerhalt des in diesen Fällen nicht degenerativ veränderten CC-Gelenks sowie eine herabgesetzte Invasivität durch Wegfall des zweiten, lateralen Zugangs der Triple-Arthrodese 60 . Im Gegensatz zu den angeführten Vorteilen berichten Burrus et al bei kleiner Fallzahl von einer deutlich erhöhten Rate an Mal- und Nonunion sowie schlechteren Ergebnissen der Outcome-Scores nach Double-Arthrodese im Vergleich zur konventionellen Triple-Arthrodese (44 vs. 0% bei n = 16) 61 .…”

Section: Chirurgische Therapie Der Rigiden Fehlstellungunclassified

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Döring¹,

Vertesich²,

Puchner³

2021

Z Orthop Unfall

View full text Add to dashboard Cite

ZusammenfassungDer erworbene Plattfuß des Erwachsenen präsentiert sich als langsam progrediente Deformität, die unbehandelt zu quälenden Schmerzen und Einschränkungen der Aktivitäten des täglichen Lebens führen kann. Die Therapiemaßnahmen sind vielfältig und abhängig von klinischer und radiologischer Präsentation, sodass für jeden Patienten eine individuelle Versorgung geplant werden muss. Dieser Beitrag spannt einen Bogen von der Ätiopathogenese über die chirurgische Therapie bis hin zur postoperativen Mobilisierung und Rehabilitation.

show abstract

Medial Double Arthrodesis With Lateral Column Sparing and Arthrodiastasis: A Radiographic and Medical Record Review

Cited by 20 publications

References 12 publications

Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Outcomes of the Extended Z-Cut Osteotomy for Correction of Adult Acquired Flatfoot Deformity

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Contact Info

Product

Resources

About