Operative Correction of Arch Collapse with Forefoot Deformity: A Retrospective Analysis of Outcomes

Habbu, Rohan; Holthusen, Scott M.; Anderson, John G.; Bohay, Donald R.

doi:10.3113/fai.2011.0764

Cited by 25 publications

(9 citation statements)

References 66 publications

(68 reference statements)

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“…2,37 Gastrocnemius-soleus tightness can lead to laxity and collapse in the arch and supporting structures of the midfoot, as well as forefoot abduction. 16,57,113 Equinus contracture limits ankle dorsiflexion, forcing the foot to evert and dorsiflex through the talonavicular or midfoot joints to continue the gait cycle. Normal ankle dorsiflexion is 20 degrees with the knee flexed or extended.…”

Section: Discussionmentioning

confidence: 99%

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Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

142

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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.

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Section: Discussionmentioning

confidence: 99%

“…As a result, these patients are typically treated with TMT fusion instead. 4,19,57 Equinus Contracture…”

Section: Cotton Osteotomy or First Tmt Fusionmentioning

confidence: 99%

Adult-Acquired Flatfoot Deformity

Henry

Shakked

Ellis

2019

Foot & Ankle Orthopaedics

142

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“…Tarsometatarsal arthrodesis is a traditional procedure for correction of forefoot varus in the setting of PCFD when severe medial column instability, TMT plantar gapping, local arthritis or hallux valgus is present (1,30,31) . Reliability of this technique and good functional results are usually the arguments that supports its indication (32,33) . Few studies analyzed the contribution of the Lapidus fusion in PCFD correction but none tested the technique in isolation (34,35) .…”

Section: Discussionmentioning

confidence: 95%

Lapicotton technique in the treatment of progressive collapsing foot deformity

Ahrenholz¹,

Iehl²,

Vivtcharenko³

et al. 2020

J Foot Ankle

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We present a technical surgical description of a 36-year-old female diagnosed with Progressive Collapsing Foot Deformity (PCFD) treated with a medial displacement calcaneus osteotomy, a lateral column lengthening, and a modified Lapidus fusion. In order to increase the plantar flexion power of this arthrodesis and minimize the loss in ray length with joint preparation, a bone block structured graft was used. Fixation was performed using a post implant in the medial cuneiform with crossing screws though the surfaces and the graft. Forefoot varus was properly corrected intraoperatively by using the described surgical technique. Satisfactory functional short-term results and an excellent alignment was accomplished. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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“…Flatfoot is a multiplanar deformity that persists or develops after skeletal maturation and is characterized by complete or partial collapse of the medial longitudinal arch. Forefoot varus is commonly associated with flatfoot [16] and surgical correction should address this deformity [17]. Forefoot varus can be corrected through a plantar flexing opening wedge osteotomy of the medial cuneiform, also known as a Cotton osteotomy [6].…”

Section: Discussionmentioning

confidence: 99%

Medial Cuneiform Opening Wedge Osteotomy for Correction of Flexible Flatfoot Deformity: Trabecular Titanium vs. Bone Allograft Wedges

Romeo

Bianchi

Cerbone

et al. 2019

BioMed Research International

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Adult flatfoot is a common pathology characterized by multiplanar deformity involving hindfoot, midfoot, and forefoot. Various surgical techniques have been described for the treatment but may not adequately correct the fixed forefoot varus component. Residual forefoot supination can be addressed by a plantar flexing opening wedge osteotomy of the medial cuneiform, also known as a Cotton osteotomy. Thus, the aims of this study were to compare clinical, radiological, and functional outcome after Cotton osteotomy, in patients treated with bone allograft or metallic implant. Consequently, 36 patients treated with opening wedge osteotomy of the medial cuneiform for forefoot varus were studied retrospectively. Patients were divided into two groups: the bone allograft group (HBG) (n=18) and the metallic implant group with BIOFOAM® Cotton Wedges (TTW) (n=18). Radiographic assessment and clinical scores including American Orthopaedic Foot and Ankle Society score, Foot Function Index, and visual analogue scale for pain were collected before operation and the last follow-up. The difference between baseline and follow-up for both groups was statistically significant for all the clinical scores and radiographic angles (p < 0.05). Most participants (92%) were very satisfied after surgery. Our results showed that Cotton osteotomy with a metallic implant provided both good clinical and radiographic outcomes comparable with bone allograft.

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Operative Correction of Arch Collapse with Forefoot Deformity: A Retrospective Analysis of Outcomes

Cited by 25 publications

References 66 publications

Adult-Acquired Flatfoot Deformity

Adult-Acquired Flatfoot Deformity

Lapicotton technique in the treatment of progressive collapsing foot deformity

Medial Cuneiform Opening Wedge Osteotomy for Correction of Flexible Flatfoot Deformity: Trabecular Titanium vs. Bone Allograft Wedges

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