Short-term efficacy of lateral column lengthening via cuboid osteotomy combined with additional procedures for the flatfoot
Objective:To evaluate the short-term efficacy of lateral column lengthening via cuboid osteotomy combined with additional procedures for flatfoot.Methods:A retrospective analysis was conducted on 14 patients(14 feet)with flatfoot who underwent lateral column lengthening with cuboid osteotomy and additional procedures at Xi'an Honghui Hospital from October 2019 to September 2021.There were 6 males and 8 females,with an average age of 24.3±5.2 years(range,12-38 years).The typical clinical manifestations included forefoot abduction,hindfoot valgus,collapse of the medial arch,and shortening of the lateral column.Pain visual analog scale(VAS),Maryland score,and American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score were compared at baseline and the final follow-up.The weight-bearing anteroposterior and lateral radiographs of the affected foot and Saltzman view of the hindfoot were taken at baseline and the final follow-up.The talus-first metatarsal angle(T1MT),talus-second metatarsal angle(T2MT),and talonavicular coverage angle(TNCA)were measured on the weight-bearing anteroposterior radiographs.The Meary angle(talus-first metatarsal angle),calcaneal pitch angle(Pitch angle),and talocalcaneal angle(Kite angle)were measured on lateral radiographs.The Saltzman valgus angle was measured on Saltzman views of the hindfoot.These measurements were compared between groups.Results:Additional procedures performed included medial displacement calcaneal osteotomy(10 patients),spring ligament repair and tightening(4 patients),posterior tibial tendon strengthening(4 patients),talonavicular joint fusion(3 patients),subtalar joint fusion(2 patients),Achilles tendon lengthening(gastrocnemius fascia release)(1 patient),and Cotton osteotomy(1 patient).Postoperative complications included one case of superficial wound infection,which healed after 1 week of oral antibiotics,two cases of allergic reactions to the lateral cuboid metallic implants,and 1 case of pain in the fifth tarsometatarsal joint.All patients were followed for 12 to 18 months,with an average follow-up period of 14.6±3.2 months.Significant improvements were observed in the VAS scores,Maryland scores and AOFAS ankle-hindfoot scores at the final follow-up.Radiographic measurements showed significant improvement in T1MT angle,T2MT angle,TNCA,Meary angle,Kite angle,and pitch angle at the final follow-up(all P<0.01).Conclusions:Lateral column lengthening via cuboid osteotomy combined with additional procedures has good short-term efficacy in the treatment of flatfoot and can effectively improve the deformity of flatfoot.
万方数据
维普
