Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity

2017 ◽  
Vol 11 (4) ◽  
pp. 347-356 ◽  
Author(s):  
Spencer H. Moore ◽  
S. Evan Carstensen ◽  
M. Tyrrell Burrus ◽  
Truitt Cooper ◽  
Joseph S. Park ◽  
...  
Keyword(s):  
Case Series ◽  
Deformity Correction ◽  
Porous Titanium ◽  
Common Procedure ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity

Lateral column lengthening (LCL) is a common procedure for reconstruction of stage II flexible adult-acquired flatfoot deformity (AAFD). The recent development of porous titanium wedges for this procedure provides an alternative to allograft and autograft. The purpose of this study was to report radiographic and clinical outcomes achieved with porous titanium wedges in LCL. A retrospective analysis of 34 feet in 30 patients with AAFD that received porous titanium wedges for LCL from January 2011 to October 2014. Deformity correction was assessed using both radiographic and clinical parameters. Radiographic correction was assessed using the lateral talo–first metatarsal angle, the talonavicular uncoverage percentage, and the first metatarsocuneiform height. The hindfoot valgus angle was measured. Patients were followed from a minimum of 6 months up to 4 years (mean 16.1 months). Postoperative radiographs demonstrated significant correction in all 3 radiographic criteria and the hindfoot valgus angle. We had no cases of nonunion, no wedge migration, and no wedges have been removed to date. The most common complication was calcaneocuboid joint pain (14.7%). Porous titanium wedges in LCL can achieve good radiographic and clinical correction of AAFD with a low rate of nonunion and other complications. Levels of Evidence: Level IV: Case series

scholarly journals Porous Titanium Wedges are an Alternative in Lateral Column Lengthening for Adult Acquired Flatfoot Deformity

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0018
Author(s):  
Samuel Carstensen ◽  
Spencer Moore ◽  
Joseph Park ◽  
M. Truitt Cooper ◽  
Venkat Perumal
Keyword(s):  
Deformity Correction ◽  
Porous Titanium ◽  
Treatment Modalities ◽  
Posterior Tibial Tendon ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Valgus Angle ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity

Category: Hindfoot Introduction/Purpose: Lateral column lengthening (LCL) is a common procedure for reconstruction of stage II flexible adult acquired flatfoot deformity (AAFD). The recent development of porous titanium wedges for this procedure provides an alternative to allograft and autograft. The purpose of this study was to report radiographic and clinical outcomes achieved with porous titanium wedges in LCL. Methods: A retrospective analysis of 34 feet in 30 patients with AAFD that received porous titanium wedges for LCL from January 2011 – October 2014. Deformity correction was assessed using both radiographic and clinical parameters. Radiographic correction was assessed using the lateral talo-first metatarsal angle, the talonavicular uncoverage percentage, and the first metatarsocuneiform height. The hindfoot valgus angle was also obtained. Results: Patients were followed from a minimum of six months up to 48 months (mean 16.1 months). Patients underwent concomitant procedures including medial displacement calcaneal osteotomy (94.1%), flexor digitorum longus transfer (70.6%), posterior tibial tendon tenolysis (64.7%), gastrocnemius recession (20.6%), and cotton osteotomy (4.9%). Postoperative radiographs demonstrated significant correction in all three radiographic criteria as well as the hindfoot valgus angle compared to their preoperative measurements. There were no cases of nonunion, no wedge migration, no infections, and no patients required removal of hardware. The most common complication was calcaneocuboid joint pain (14.7%). Conclusion: AAFD is a problem with various treatment modalities. Porous titanium wedges in LCL can achieve good radiographic and clinical correction of AAFD with a low rate of nonunion and other complications.

A Modified Extra-articular Lateral Column Lengthening Procedure for Adult Acquired Flatfoot Deformity

2021 ◽  
pp. 107110072110513
Author(s):  
Yin-Chuan Shih ◽  
Chui Jia Farn ◽  
Chen-Chie Wang ◽  
Chung-Li Wang ◽  
Pei-Yu Chen
Keyword(s):  
Subtalar Joint ◽  
Case Series ◽  
Stage Ii ◽  
Posterior Tibial Tendon ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity ◽  
The Mean

Background: Lateral column lengthening (LCL), originally described by Evans, is an established procedure to correct stage II adult acquired flatfoot deformity (AAFD). However, the relative position between the facets is violated, and other problems may include nonunion, malunion, and calcaneocuboid (CC) joint subluxation. Herein, we report a modified extra-articular technique of LCL with hockey-stick osteotomy, which preserves the subtalar joint as a whole, increases bony apposition to enhance healing ability, and preserves the insertion of the calcaneofibular ligament to stabilize the posterior fragment to promote adduction of the forefoot. Methods: We retrospectively recruited 24 patients (26 feet) with stage II AAFD who underwent extra-articular LCL. The mean age was 55.7 ± 15.7 years, and the mean follow-up period was 33.4 ± 12.1 months. Associated procedures of spring ligament repair/reconstruction and posterior tibial tendon plication or flexor digitorum longus transfer were routinely performed and may also include a Cotton osteotomy, heel cord lengthening, or hallux valgus correction. Clinical and radiographic outcomes at the final follow-up were compared with the preoperative assessments. Results: All patients achieved calcaneus union within 3 months of operation. The VAS pain score improved from 5.3 ± 0.75 preoperatively to 1.2 ± 0.79 at the final follow-up ( P < .001), and the AOFAS Ankle-Hindfoot Scale from 63.5 ± 8.5 to 85.8 ± 4.8 points ( P < .001). The radiographic measurements significantly improved in terms of the preoperative vs final angles of 8.9 ± 5.3 vs 15.2 ± 3.6 degrees for calcaneal pitch ( P < .001), 20.5 ± 9.2 vs 4.9 ± 4.8 degrees for Meary angle ( P < .001), 46.5 ± 5.2 vs 41.9 ± 3.2 degrees for lateral talocalcaneal angle ( P < .001), 23.9 ± 8.5 vs 3.9 ± 3.1 degrees for talonavicular coverage angle ( P < .001), and 18.2 ± 9.2 vs 7.3 ± 5.0 degrees for talus-first metatarsal angle ( P = .002). The CC joint subluxation percentage was 7.0% ± 5.4% preoperatively compared with 8.5% ± 2.4% at the final follow-up ( P = .101). No case showed progression of CC joint arthritis or CC joint subluxation (>15% CC joint subluxation percentage). One case showed transient sural nerve territory paresthesia, and 1 had pin tract infection. Three cases had lateral foot pain, which could be relieved by custom insoles. Conclusion: Modified extra-articular LCL as part of AAFD correction is a feasible alternative technique without subtalar joint invasion and may be associated with less CC joint subluxation compared with the Evans osteotomy. Level of Evidence: Level IV, retrospective case series.

scholarly journals Union Rates and Deformity Correction Using the Hintermann Osteotomy in Type IIb Flatfoot Deformity

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0022
Author(s):  
Brian P. Gallagher ◽  
Walter C. Hembree ◽  
Lew C. Schon
Keyword(s):  
Articular Cartilage ◽  
Clinical Signs ◽  
Deformity Correction ◽  
Degenerative Changes ◽  
Stage Ii ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Radiographic Union

Category: Ankle; Hindfoot Introduction/Purpose: Multiple Lateral column lengthening procedures have been described for the correction of the abduction component of stage II flatfoot deformity. The Hintermann osteotomy, although technically difficult, offers powerful lengthening of the lateral column with low risk of violating the articular cartilage of the subtalar joint as compared to the more widely performed Evans osteotomy. This study reports on the radiographic and clinical outcomes of the Hintermann osteotomy performed by a single surgeon. Methods: Patients who underwent reconstruction for stage II flatfoot deformity with a Hintermann lateral column lengthening were restrospectively identified. The talus-1st metatarsal angle, percent talus uncoverage, calcaneal pitch, lateral column length, CC joint subluxation, and distance from CC joint to the osteotomy were measured on pre and postop radiographs. Radiographic union was also assessed. The Kellgren-Lawrence scale was used to assess degenerative changes at the ST, CC, and TN joints. Charts were reviewed for comorbidities, clinical evidence of union, time to protected weightbearing, time to unrestricted weightbearing, signs of peroneal irritation, clinical signs of osteoarthritis progression, and complications. A paired students t test was used to identify differences in radiographic parameters. Results: Twenty-six patients (30 feet) met inclusion criteria. All osteotomies achieved union with only 1 (1/30) instance of delayed union. Average duration before clinical and radiographic union was 12.6 weeks (9-37). The AP Talus-1st metatarsal angle decreased on average of 12.3 degrees (STD 9.1) (p<0.0001). Percent talus uncoverage decreased on average 17.7 percent (STD 11.5%) (p<0.0001). Subluxation at the CC joint was found to increase on average 1.63mm (STD 1.99) (p<0.01). Only 3 patients (10%) had radiographic progression of osteoarthritis at either the CC or ST joint. No patients showed clinical signs of osteoarthritis and none went on to fusion. One patient had lateral hardware pain necessitating plate removal. Conclusion: The Hintermann osteotomy is a powerful tool for lateral column lengthening. In this series there was significant correction of the preoperative abduction deformity with no nonunions. Degenerative changes in the surrounding hindfoot joints were rare. One benefit of the Hintermann osteotomy is its ability to preserve the articular cartilage of the anterior and middle facets.

scholarly journals Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for StageⅡB Adult- acquired Flatfoot Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Yunfeng Yang ◽  
Haichao Zhou ◽  
Yun Zhang
Keyword(s):  
Lateral Pressure ◽  
Biomechanical Analysis ◽  
Good Effect ◽  
Lateral Column ◽  
First Metatarsal ◽  
Metatarsal Angle ◽  
Significant Difference ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity

Category: Basic Sciences/Biologics Introduction/Purpose: To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage? B adult-acquired flatfoot deformity in cadaver. Methods: Six cadaver specimens were compressively loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results: Compared with the flatfoot model, the 2-,3-,4-, and 5-mm LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs. As the graft increased in size incrementally, lateral forefoot pressure increased consistently, and medial pressure decreased significantly except for the 2-mm LCL. Compared with the intact foot, the above angles of the LCLs showed no significant difference except for the 2- mm LCL. In terms of forefoot pressure, medial pressure of the 2-mm LCL and lateral pressure of the 3-, 4- and 5-mm LCLs showed statistical differences, but lateral pressure of the 3-mm LCL was not much more than the intact foot as compared to the 4- and 5-mm LCLs, which was still less than medial pressure. Conclusion: Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage? B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

scholarly journals Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Haichao Zhou ◽  
Haoyang Ren ◽  
Chunguang Li ◽  
Jiang Xia ◽  
Guangrong Yu ◽  
...  
Keyword(s):  
Lateral Pressure ◽  
Biomechanical Analysis ◽  
Stage Ii ◽  
Good Effect ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Significant Difference ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity

Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p<.05). Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p=.044) and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p<.05), but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

scholarly journals Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Yunfeng Yang
Keyword(s):  
Lateral Pressure ◽  
Biomechanical Analysis ◽  
Stage Ii ◽  
Good Effect ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Significant Difference ◽  
Significant Correction ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity

Category: Midfoot/Forefoot Introduction/Purpose: To investigate the effect of cuboid osteotomy lateral column lengthening (LCL) for the correction of stage II B adultacquired flatfoot deformity in cadaver Methods: Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1) intact foot, (2) flatfoot, and (3) cuboid osteotomy LCL (2, 3, 4, and 5 mm). Results: Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs ( p < .05). Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2mmLCL. In terms of forefoot pressure, medial pressure of the 2mmLCL ( p = .044) and lateral pressure of the 3, 4, and 5mmLCLs showed statistical differences ( p < .05), but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion: Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

scholarly journals The Effect of Lateral Column Lengthening on Subtalar Motion: Are We Trading Deformity for Stiffness?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0004
Author(s):  
Brittany Hedrick ◽  
Anthony Riccio ◽  
Danielle M. Thomas ◽  
Claire Shivers ◽  
Matthew Siebert ◽  
...  
Keyword(s):  
Motion Capture ◽  
Three Dimensional ◽  
Deformity Correction ◽  
Porous Titanium ◽  
Testing System ◽  
Materials Testing ◽  
Lateral Column ◽  
Fresh Frozen ◽  
Lateral Column Lengthening ◽  
Paired T Test

Category: Hindfoot; Other Introduction/Purpose: While lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra- articular osteotomy on subtalar motion. The purpose of this study is to quantify the alterations in subtalar motion following lateral column lengthening (LCL). Methods: The subtalar motion of 14 fresh frozen cadaveric feet was assessed using a three-dimensional motion capture system and materials testing system (MTS). Following potting of the tibia and calcaneus, optic markers were placed into the tibia, calcaneus and talus. The MTS was used to apply a rotational force across the subtalar joint to a torque of 5Nm. Abduction/adduction, supination/pronation, and plantarflexion/dorsiflexion about the talus was recorded. Specimens then underwent LCL via a calcaneal neck osteotomy which was maintained with a 12mm porous titanium wedge. Repeat subtalar motion analysis was performed and compared to pre-LCL motion using a paired t-test. Results:: No statistically significant differences in subtalar abduction/adduction (10.9O vs. 11.8O degrees, p=.48), supination/pronation (3.5O vs. 2.7O, p=.31), or plantarflexion/dorsiflexion (1.6O vs 1.0O, p=.10) were identified following LCL. Conclusion:: No significant changes in subtalar motion were observed following lateral column lengthening in this biomechanical cadaveric study. While these findings do not obviate concerns of clinical subtalar stiffness following planovalgus deformity correction, they suggest that diminished postoperative subtalar motion may be due to soft tissue scarring rather than alterations of joint anatomy.

Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity

2017 ◽  
Vol 39 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Stuart M. Saunders ◽  
Scott J. Ellis ◽  
Constantine A. Demetracopoulos ◽  
Anca Marinescu ◽  
Jayme Burkett ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Categorical Variables ◽  
Distributed Data ◽  
Level Of Evidence ◽  
Lateral Column ◽  
Calcaneal Osteotomy ◽  
Outcome Scores ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity ◽  
Lateral Pain

Background: The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. Methods: We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant). Results: The Evans group used a larger graft size ( P < .001) and returned more often for hardware removal ( P = .038) than the SLCO group. SLCO union occurred at a mean of 8.77 weeks ( P < .001), which was significantly lower compared with the Evans group ( P = .02). The SLCO group also had fewer nonunions ( P = .016). FAOS scores improved equivalently between the 2 groups. Lateral column pain, ability to exercise, and ambulation distance were similar between groups. Conclusion: Following SLCO, patients had faster healing times and fewer nonunions, similar outcomes scores, and equivalent correction of deformity. SLCO is a viable technique for lateral column lengthening. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Outcome of Bunion Correction with First Tarsometatarsal Arthrodesis in Adult Acquired Flatfoot Deformity Correction

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0012
Author(s):  
Thomas B. Bemenderfer ◽  
Jacob B. Boersma ◽  
Michael J. Pryor ◽  
John D. Maskill ◽  
Donald R. Bohay ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Wound Care ◽  
Weight Bearing ◽  
Case Series ◽  
Deformity Correction ◽  
Lateral Column ◽  
Radiographic Outcomes ◽  
Radiographic Measurements ◽  
Tertiary Center ◽  
Adult Acquired Flatfoot Deformity

Category: Bunion; Hindfoot; Midfoot/Forefoot Introduction/Purpose: Arthrodesis of the first tarsometatarsal (TMT-1) joint is a widely accepted procedure for treatment of hallux valgus (HV) with medial column instability secondary to unstable first ray, midfoot arthritis, and severe or recurrent deformities with high intermetatarsal angles (IMA). This study aimed to evaluate clinical and radiographic outcomes in patients with mild-to-severe HV who underwent TMT-1 arthrodesis and proximal hindfoot correction for adult acquired flatfoot deformity (AAFD). Methods: All patients with symptomatic HV and AAFD who failed conservative management underwent TMT-1 fusion and proximal hindfoot correction (medial displacement calcaneal osteotomy, lateral column lengthening, subtalar fusion, or tibiotalocalcaneal fusion) by one of three senior foot and ankle surgeons at a single tertiary center between January 2006 and December 2018 were included in our retrospective case series. Demographics, clinical outcomes, patient comorbidity information, and radiographic outcomes including hallux valgus angle (HVA), IMA 1-2, hallux valgus interphalangeus angle, distal metatarsal articular angle, and sesamoid station were collected. The primary outcome was change in HVA measured as the difference between final postoperative and preoperative weight bearing HVA measurements. Secondary outcomes were reoperation, minor complications (local wound care, use of antibiotics, and skin dehiscence), and change in radiographic measurements. Results: With an average follow up of 26 months, 155 patients (17.4% male, 82.6% female; average age 59.0 years old, range 18 to 84) met inclusion. The average change in HVA was -18.6 degrees (range +15.8 to -81.0). There was a total of 85 reoperations in 35.5% (n=55; 48 hardware removal). Minor complications were present in 18.7% (n=29; 25 local wound care, 23 use of antibiotics, and 10 skin dehiscence). 44.5% (n=69) had no evidence of recurrent HV while mild, moderate, and severe grade bunions were present in 40.0% (n=62), 5.2% (n=8), and 0.6% (n=1). Improvement in overall bunion grade was maintained in 69.7% (n=108) with no change in 19.4% (n=30). Hallux varus was present in 9.7% (n=15; 3 underwent TMT-1 arthrodesis). Conclusion: The present study demonstrates a significant improvement in HVA following TMT-1 arthrodesis and proximal hindfoot correction for AAFD. The majority of patients undergoing TMT-1 arthrodesis and proximal hindfoot correction for AAFD obtain and maintain improvement in the radiographic severity of their bunions. However, patients should be counseled concerning expectations with regards to outcomes associated with complex AAFD reconstructions.

Severe Flexible Pes Planovalgus Deformity Correction Using Trabecular Metallic Wedges

2018 ◽  
Vol 40 (4) ◽  
pp. 402-407 ◽  
Author(s):  
Justin Tsai ◽  
Elizabeth McDonald ◽  
Ryan Sutton ◽  
Steven M. Raikin
Keyword(s):  
Case Series ◽  
Deformity Correction ◽  
Wedge Osteotomy ◽  
Attractive Alternative ◽  
Pes Planovalgus ◽  
Lateral Column ◽  
Metatarsal Angle ◽  
Radiographic Measurements ◽  
Functional Scores

Background: Lateral column lengthening and plantarflexion dorsal opening wedge osteotomy of the medial cuneiform are 2 commonly used procedures to address the deformity seen in severe flexible pes planovalgus deformity. Traditionally, iliac crest allograft or autograft has been used to fill the osteotomy sites. Porous metallic wedges can be used as an alternative to avoid the concerns associated with both autograft and allograft. Methods: We performed a retrospective review of patients who had corrective osteotomies utilizing metallic wedges to address flexible pes planovalgus with at least 2 years of follow-up data. Preoperative radiographic measurements (anteroposterior [AP] and talo-first metatarsal angle, calcaneal pitch, talocalcaneal angle, and talonavicular uncoverage angle) and functional scores (visual analog scale [VAS] pain, Foot and Ankle Ability Measure [FAAM] Activities of Daily Living [ADL], FAAM Sports) were compared to postoperative radiographic measurements and functional scores. Results: There were statistically significant improvements in all radiographic parameters and functional scores. Two nonunions were seen, one of which healed with revision surgery while the other was asymptomatic. At the time of last radiographic follow-up, there were no recurrences of deformity or collapse. Conclusion: Porous metallic wedges offer an attractive alternative to autograft and/or allograft in the setting of corrective osteotomies for severe flexible pes planovalgus. Patients who underwent corrective osteotomies using these wedges demonstrated reliable, effective, and stable radiographic correction as well as significant improvements in function and pain. Level of Evidence: Level IV, case series.

Sign in / Sign up

Export Citation Format

Share Document