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Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin.
Foot Ankle Int. 2009 Jan; 30(1):21-6.FA

Abstract

BACKGROUND

Triple arthrodesis through a two-incision approach is the traditional surgical treatment of fixed flatfoot in adults. However, since it limits motion and forces the remaining joints to absorb more load, long-term studies report diminishing results over time from symptomatic breakdown of adjacent joints. In addition, wound-healing problems have been reported in up one-third of patients undergoing a major flatfoot reconstruction which are more commonly associated with the anterolateral approaches. Therefore, since 2003, we have been interested in selective arthrodesis of the subtalar and talonavicular joints sparing the uninvolved calcaneocuboid joint and the lateral skin.

MATERIALS AND METHOD

We have performed this procedure in 11 patients (14 feet) who had deficient lateral skin and a fixed hindfoot valgus deformity where adequate correction may have led to lateral wound complication. They were followed in a prospective fashion and assessed at a minimum of 6 months followup.

RESULTS

Wound healing occurred without any complications in all cases. Evaluation was performed at an average of 21.5 (range, 6 to 50) months. Significant radiographic improvements were observed on each measurement: anteroposterior talonavicular coverage angle improved from 38.5 degrees to 7 degrees, lateral talo-first metatarsal angle improved from 21 degrees to 0 degrees, hindfoot frontal alignment angle improved from 18 degrees to 7.5 degrees. All patients had an asymptomatic calcaneocuboid joint.

CONCLUSION

Arthrodesis of the subtalar and talonavicular joints through a medial approach combined with peroneal lengthening is a reliable procedure for the treatment of rigid flatfoot with deficient lateral skin without calcaneocuboid joint degeneration.

Authors+Show Affiliations

C.H.R.U. Tours, Hôpital Trousseau, Service de Chirurgie Orthopédique 1, Tours F-37000, France. jean.brilhault@gmail.com

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19176181

Citation

Brilhault, Jean. "Single Medial Approach to Modified Double Arthrodesis in Rigid Flatfoot With Lateral Deficient Skin." Foot & Ankle International, vol. 30, no. 1, 2009, pp. 21-6.
Brilhault J. Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin. Foot Ankle Int. 2009;30(1):21-6.
Brilhault, J. (2009). Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin. Foot & Ankle International, 30(1), 21-6. https://doi.org/10.3113/FAI.2009.0021
Brilhault J. Single Medial Approach to Modified Double Arthrodesis in Rigid Flatfoot With Lateral Deficient Skin. Foot Ankle Int. 2009;30(1):21-6. PubMed PMID: 19176181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin. A1 - Brilhault,Jean, PY - 2009/1/30/entrez PY - 2009/1/30/pubmed PY - 2009/3/4/medline SP - 21 EP - 6 JF - Foot & ankle international JO - Foot Ankle Int VL - 30 IS - 1 N2 - BACKGROUND: Triple arthrodesis through a two-incision approach is the traditional surgical treatment of fixed flatfoot in adults. However, since it limits motion and forces the remaining joints to absorb more load, long-term studies report diminishing results over time from symptomatic breakdown of adjacent joints. In addition, wound-healing problems have been reported in up one-third of patients undergoing a major flatfoot reconstruction which are more commonly associated with the anterolateral approaches. Therefore, since 2003, we have been interested in selective arthrodesis of the subtalar and talonavicular joints sparing the uninvolved calcaneocuboid joint and the lateral skin. MATERIALS AND METHOD: We have performed this procedure in 11 patients (14 feet) who had deficient lateral skin and a fixed hindfoot valgus deformity where adequate correction may have led to lateral wound complication. They were followed in a prospective fashion and assessed at a minimum of 6 months followup. RESULTS: Wound healing occurred without any complications in all cases. Evaluation was performed at an average of 21.5 (range, 6 to 50) months. Significant radiographic improvements were observed on each measurement: anteroposterior talonavicular coverage angle improved from 38.5 degrees to 7 degrees, lateral talo-first metatarsal angle improved from 21 degrees to 0 degrees, hindfoot frontal alignment angle improved from 18 degrees to 7.5 degrees. All patients had an asymptomatic calcaneocuboid joint. CONCLUSION: Arthrodesis of the subtalar and talonavicular joints through a medial approach combined with peroneal lengthening is a reliable procedure for the treatment of rigid flatfoot with deficient lateral skin without calcaneocuboid joint degeneration. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/19176181/Single_medial_approach_to_modified_double_arthrodesis_in_rigid_flatfoot_with_lateral_deficient_skin_ L2 - http://journals.sagepub.com/doi/full/10.3113/FAI.2009.0021?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -