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Radiographic analysis of an opening wedge osteotomy of the medial cuneiform.
Foot Ankle Int. 2011 Mar; 32(3):278-87.FA

Abstract

BACKGROUND

Forefoot varus deformity and medial column instability can develop or be present in association with ankle and hindfoot pathology. This study aimed to confirm the utility of medial cuneiform opening wedge osteotomy as part of hindfoot and ankle deformity correction.

MATERIALS AND METHODS

Patients requiring operative management of flatfoot deformity between January 2002 and December 2007 were prospectively entered in a database. We selected all patients who underwent medial cuneiform opening wedge osteotomy. One hundred and one feet in 86 patients of mean age 36 (range, 9 to 80) years were evaluated. Eighty-one feet had adequate radiographic imaging for assessment. Concomitant procedures were performed. We measured standardized, validated radiographic parameters on pre- and postoperative weightbearing foot radiographs. Variables including concomitant surgical procedures, osteotomy union, malunion, and midfoot arthritis were noted.

RESULTS

The mean lateral talus-first metatarsal angle improved from 23 degrees to 1 degrees (p < 0.001); mean medial cuneiform to floor distance improved from 20 mm to 34 mm (p < 0.001); mean talar declination angle improved from 39 degrees to 27 degrees (p < 0.001); mean calcaneal-talar angle improved from 64 degrees to 55 degrees (p < 0.001); calcaneal pitch angle improved from 14 degrees to 23 degrees (p < 0.001); mean first metatarsal declination angle improved from 17 degrees to 26 degrees (p < 0.001); mean talonavicular coverage angle improved from 45 degrees to 18 degrees (p < 0.001); and mean anteroposterior talus-first metatarsal angle improved from 19 degrees to 0 degrees (p < 0.001).

CONCLUSION

Radiographical analysis showed that medial cuneiform opening wedge osteotomy combined with other corrective procedures corrected forefoot varus, elevated first metatarsal and medial column instability radiographic parameters that are most commonly associated with flatfoot deformity.

Authors+Show Affiliations

The Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21477547

Citation

Lutz, Michael, and Mark Myerson. "Radiographic Analysis of an Opening Wedge Osteotomy of the Medial Cuneiform." Foot & Ankle International, vol. 32, no. 3, 2011, pp. 278-87.
Lutz M, Myerson M. Radiographic analysis of an opening wedge osteotomy of the medial cuneiform. Foot Ankle Int. 2011;32(3):278-87.
Lutz, M., & Myerson, M. (2011). Radiographic analysis of an opening wedge osteotomy of the medial cuneiform. Foot & Ankle International, 32(3), 278-87. https://doi.org/10.3113/FAI.2011.0278
Lutz M, Myerson M. Radiographic Analysis of an Opening Wedge Osteotomy of the Medial Cuneiform. Foot Ankle Int. 2011;32(3):278-87. PubMed PMID: 21477547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiographic analysis of an opening wedge osteotomy of the medial cuneiform. AU - Lutz,Michael, AU - Myerson,Mark, PY - 2011/4/12/entrez PY - 2011/4/12/pubmed PY - 2011/5/26/medline SP - 278 EP - 87 JF - Foot & ankle international JO - Foot Ankle Int VL - 32 IS - 3 N2 - BACKGROUND: Forefoot varus deformity and medial column instability can develop or be present in association with ankle and hindfoot pathology. This study aimed to confirm the utility of medial cuneiform opening wedge osteotomy as part of hindfoot and ankle deformity correction. MATERIALS AND METHODS: Patients requiring operative management of flatfoot deformity between January 2002 and December 2007 were prospectively entered in a database. We selected all patients who underwent medial cuneiform opening wedge osteotomy. One hundred and one feet in 86 patients of mean age 36 (range, 9 to 80) years were evaluated. Eighty-one feet had adequate radiographic imaging for assessment. Concomitant procedures were performed. We measured standardized, validated radiographic parameters on pre- and postoperative weightbearing foot radiographs. Variables including concomitant surgical procedures, osteotomy union, malunion, and midfoot arthritis were noted. RESULTS: The mean lateral talus-first metatarsal angle improved from 23 degrees to 1 degrees (p < 0.001); mean medial cuneiform to floor distance improved from 20 mm to 34 mm (p < 0.001); mean talar declination angle improved from 39 degrees to 27 degrees (p < 0.001); mean calcaneal-talar angle improved from 64 degrees to 55 degrees (p < 0.001); calcaneal pitch angle improved from 14 degrees to 23 degrees (p < 0.001); mean first metatarsal declination angle improved from 17 degrees to 26 degrees (p < 0.001); mean talonavicular coverage angle improved from 45 degrees to 18 degrees (p < 0.001); and mean anteroposterior talus-first metatarsal angle improved from 19 degrees to 0 degrees (p < 0.001). CONCLUSION: Radiographical analysis showed that medial cuneiform opening wedge osteotomy combined with other corrective procedures corrected forefoot varus, elevated first metatarsal and medial column instability radiographic parameters that are most commonly associated with flatfoot deformity. SN - 1071-1007 UR - https://www.unboundmedicine.com/medline/citation/21477547/Radiographic_analysis_of_an_opening_wedge_osteotomy_of_the_medial_cuneiform_ L2 - http://journals.sagepub.com/doi/full/10.3113/FAI.2011.0278?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -