Tags

Type your tag names separated by a space and hit enter

Plantar pressures in the forefoot after lateral column lengthening: a cadaver study comparing the Evans osteotomy and calcaneocuboid fusion.
Foot Ankle Int. 2005 Jul; 26(7):520-5.FA

Abstract

BACKGROUND

Excessive varus alignment of the forefoot after lateral column lengthening has been reported to lead to overloading of the lateral foot. The purpose of this study was to investigate whether there is a difference between the Evans opening wedge calcaneal osteotomy (Evans) and the calcaneocuboid distraction arthrodesis (CCDA) with respect to lateral forefoot loading.

METHODS

In each of 12 matched pairs of cadaver feet, plantar pressure measurements of the intact specimens were obtained during simulated foot-flat and early heel-rise phases of gait and again after randomly performing the Evans procedure on one foot and the CCDA on the other foot. Cervical plate fixation was used for immediate stability.

RESULTS

Both procedures resulted in statistically significant increased loading of the lateral forefoot and decreased loading of the medial forefoot compared with the preoperative status. The relative increase in lateral pressures was statistically greater with the CCDA than with the Evans. The average increase in pressure under the fifth metatarsal head in the foot-flat phase was 46% +/- 42% (range-4% to 141%) with the Evans and 104% +/- 58% (range 9% to 216%) with the CCDA (p = 0.003). In the early heel-rise phase, the increase in pressure was 50% +/- 43% (range 2% to 108%) and 96% +/- 65% (range 12% to 263%), respectively (p = 0.02).

CONCLUSION

The experimental data suggest that lateral column overload may be more likely with the CCDA than with the Evans. Physicians should be aware of the likelihood of increasing lateral column loads with both the CCDA and the Evans procedure. It may be possible to avoid this problem by using less lateral column lengthening than the 1 cm used in this study or by considering a medial column arthrodesis or plantarflexion osteotomy to balance forefoot loading.

Authors+Show Affiliations

Department of Orthopedics, Union Memorial Hospital, Baltimore, MD.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16045841

Citation

Tien, Tudor R., et al. "Plantar Pressures in the Forefoot After Lateral Column Lengthening: a Cadaver Study Comparing the Evans Osteotomy and Calcaneocuboid Fusion." Foot & Ankle International, vol. 26, no. 7, 2005, pp. 520-5.
Tien TR, Parks BG, Guyton GP. Plantar pressures in the forefoot after lateral column lengthening: a cadaver study comparing the Evans osteotomy and calcaneocuboid fusion. Foot Ankle Int. 2005;26(7):520-5.
Tien, T. R., Parks, B. G., & Guyton, G. P. (2005). Plantar pressures in the forefoot after lateral column lengthening: a cadaver study comparing the Evans osteotomy and calcaneocuboid fusion. Foot & Ankle International, 26(7), 520-5.
Tien TR, Parks BG, Guyton GP. Plantar Pressures in the Forefoot After Lateral Column Lengthening: a Cadaver Study Comparing the Evans Osteotomy and Calcaneocuboid Fusion. Foot Ankle Int. 2005;26(7):520-5. PubMed PMID: 16045841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plantar pressures in the forefoot after lateral column lengthening: a cadaver study comparing the Evans osteotomy and calcaneocuboid fusion. AU - Tien,Tudor R, AU - Parks,Brent G, AU - Guyton,Gregory P, PY - 2005/7/28/pubmed PY - 2005/10/18/medline PY - 2005/7/28/entrez SP - 520 EP - 5 JF - Foot & ankle international JO - Foot Ankle Int VL - 26 IS - 7 N2 - BACKGROUND: Excessive varus alignment of the forefoot after lateral column lengthening has been reported to lead to overloading of the lateral foot. The purpose of this study was to investigate whether there is a difference between the Evans opening wedge calcaneal osteotomy (Evans) and the calcaneocuboid distraction arthrodesis (CCDA) with respect to lateral forefoot loading. METHODS: In each of 12 matched pairs of cadaver feet, plantar pressure measurements of the intact specimens were obtained during simulated foot-flat and early heel-rise phases of gait and again after randomly performing the Evans procedure on one foot and the CCDA on the other foot. Cervical plate fixation was used for immediate stability. RESULTS: Both procedures resulted in statistically significant increased loading of the lateral forefoot and decreased loading of the medial forefoot compared with the preoperative status. The relative increase in lateral pressures was statistically greater with the CCDA than with the Evans. The average increase in pressure under the fifth metatarsal head in the foot-flat phase was 46% +/- 42% (range-4% to 141%) with the Evans and 104% +/- 58% (range 9% to 216%) with the CCDA (p = 0.003). In the early heel-rise phase, the increase in pressure was 50% +/- 43% (range 2% to 108%) and 96% +/- 65% (range 12% to 263%), respectively (p = 0.02). CONCLUSION: The experimental data suggest that lateral column overload may be more likely with the CCDA than with the Evans. Physicians should be aware of the likelihood of increasing lateral column loads with both the CCDA and the Evans procedure. It may be possible to avoid this problem by using less lateral column lengthening than the 1 cm used in this study or by considering a medial column arthrodesis or plantarflexion osteotomy to balance forefoot loading. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/16045841/Plantar_pressures_in_the_forefoot_after_lateral_column_lengthening:_a_cadaver_study_comparing_the_Evans_osteotomy_and_calcaneocuboid_fusion_ L2 - http://journals.sagepub.com/doi/full/10.1177/107110070502600704?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -