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Outcome of medial displacement calcaneal osteotomy for correction of adult-acquired flatfoot.

AbstractBACKGROUND:
The results of medial displacement calcaneal osteotomy (MDCO) with flexor digitorum longus (FDL) tendon transfer were reviewed, as well as postoperative radiographic changes, to determine quantitative x-ray-based indications for MDCO with FDL tendon transfer in cases of adult-acquired flatfoot.
MATERIALS AND METHODS:
Twenty-five patients, ages 42 to 71 years, underwent MDCO with FDL tendon transfer for stage II posterior tibial tendon dysfunction. Follow-up was 2.6 to 10.2 years. Preoperative and postoperative Japanese Society for Surgery of the Foot (JSSF), Foot Function Index, and SF-36 scores and physical and radiographic findings were compared. Eight measures of foot alignment were obtained from weight-bearing radiographs at 3, 6, 9, and 12 months after surgery and every 6 months thereafter. Differences in scores and values over time were analyzed statistically.
RESULTS:
Average JSSF scores improved from 59 preoperatively to 91.3 postoperatively (p < .001). The only x-ray parameters that improved significantly and showed maintenance of the surgical correction were the lateral talometatarsal (LTMT) and tibiocalcaneal (TBC) angles. With preoperative LTMT and TBC angles of >25° and >15°, respectively, correction was inadequate.
CONCLUSIONS:
It was concluded that indications for MDCO with FDL tendon transfer in cases of adult-acquired flatfoot are a preoperative LTMT angle of <25° and hindfoot coronal alignment (TBC angle) of <15°.
AuthorsHisateru Niki, Takaaki Hirano, Hirokazu Okada, Moroe Beppu
JournalFoot & ankle international (Foot Ankle Int) Vol. 33 Issue 11 Pg. 940-6 (Nov 2012) ISSN: 1071-1007 [Print] United States
PMID23131439 (Publication Type: Journal Article)
Topics
  • Adult
  • Aged
  • Calcaneus (surgery)
  • Female
  • Flatfoot (diagnostic imaging, etiology, surgery)
  • Humans
  • Male
  • Middle Aged
  • Osteotomy (methods)
  • Pain Measurement
  • Posterior Tibial Tendon Dysfunction (complications, surgery)
  • Postoperative Complications
  • Radiography
  • Retrospective Studies
  • Tendon Transfer

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