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Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction.
Foot Ankle Int. 2016 Nov; 37(11):1225-1231.FA

Abstract

BACKGROUND

The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot.

METHODS

Data were analyzed for 16 patients (20 feet) who had flatfoot without tibialis posterior tendon dysfunction and were treated by calcaneal Z osteotomy combined with arthroereisis between October 2011 and February 2015. The mean age of patients at the time of surgery was 12.8 ± 1.4 years (range, 10-14 years). Preoperative and postoperative measurements included changes in hindfoot valgus angles; changes in talonavicular uncoverage angles on anteroposterior (AP) radiographic view; and changes in talo-first metatarsal angles, talar pitch angles, and calcaneal pitch angles on lateral radiographic view. The American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AH) was used to assess foot function. The mean follow-up was 18.9 ± 6.9 months (range, 13-33 months).

RESULTS

The hindfoot valgus angle improved from 14.9 ± 4.2 degrees to 2.3 ± 1.7 degrees. On the AP view, the preoperative and postoperative talonavicular uncoverage angles were 30.5 ± 9.4 degrees and 9.8 ± 4.8 degrees, respectively. On lateral radiographs, the preoperative talo-first metatarsal angle, talar pitch angle, and calcaneal pitch angle were -22.1 ± 7.9 degrees, 36.1 ± 4.4 degrees, and 14.4 ± 4.0 degrees, respectively. Postoperative lateral radiographs demonstrated talo-first metatarsal angle, talar pitch angle, and calcaneal pitch angle of -6.2 ± 4.7 degrees, 27.3 ± 4.9 degrees, and 19.0 ± 4.3 degrees, respectively. The AOFAS-AH score improved from 66.8 ± 24.1 preoperatively to 96.5 ± 3.4 postoperatively.

CONCLUSIONS

For adolescents with flatfoot, calcaneal Z osteotomy combined with subtalar arthroereisis provided satisfactory results.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

Authors+Show Affiliations

Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Shanghai Institute of Traumatology and Orthopedics, Shanghai, China.Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Shanghai Institute of Traumatology and Orthopedics, Shanghai, China.Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China xu664531@hotmail.com. Shanghai Institute of Traumatology and Orthopedics, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27402620

Citation

Xu, Yang, et al. "Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction." Foot & Ankle International, vol. 37, no. 11, 2016, pp. 1225-1231.
Xu Y, Li XC, Xu XY. Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction. Foot Ankle Int. 2016;37(11):1225-1231.
Xu, Y., Li, X. C., & Xu, X. Y. (2016). Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction. Foot & Ankle International, 37(11), 1225-1231.
Xu Y, Li XC, Xu XY. Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction. Foot Ankle Int. 2016;37(11):1225-1231. PubMed PMID: 27402620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction. AU - Xu,Yang, AU - Li,Xing-Chen, AU - Xu,Xiang-Yang, Y1 - 2016/07/09/ PY - 2016/11/5/pubmed PY - 2017/8/8/medline PY - 2016/7/13/entrez KW - arthroereisis KW - flatfoot KW - lateral column lengthening KW - reconstruction SP - 1225 EP - 1231 JF - Foot & ankle international JO - Foot Ankle Int VL - 37 IS - 11 N2 - BACKGROUND: The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS: Data were analyzed for 16 patients (20 feet) who had flatfoot without tibialis posterior tendon dysfunction and were treated by calcaneal Z osteotomy combined with arthroereisis between October 2011 and February 2015. The mean age of patients at the time of surgery was 12.8 ± 1.4 years (range, 10-14 years). Preoperative and postoperative measurements included changes in hindfoot valgus angles; changes in talonavicular uncoverage angles on anteroposterior (AP) radiographic view; and changes in talo-first metatarsal angles, talar pitch angles, and calcaneal pitch angles on lateral radiographic view. The American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AH) was used to assess foot function. The mean follow-up was 18.9 ± 6.9 months (range, 13-33 months). RESULTS: The hindfoot valgus angle improved from 14.9 ± 4.2 degrees to 2.3 ± 1.7 degrees. On the AP view, the preoperative and postoperative talonavicular uncoverage angles were 30.5 ± 9.4 degrees and 9.8 ± 4.8 degrees, respectively. On lateral radiographs, the preoperative talo-first metatarsal angle, talar pitch angle, and calcaneal pitch angle were -22.1 ± 7.9 degrees, 36.1 ± 4.4 degrees, and 14.4 ± 4.0 degrees, respectively. Postoperative lateral radiographs demonstrated talo-first metatarsal angle, talar pitch angle, and calcaneal pitch angle of -6.2 ± 4.7 degrees, 27.3 ± 4.9 degrees, and 19.0 ± 4.3 degrees, respectively. The AOFAS-AH score improved from 66.8 ± 24.1 preoperatively to 96.5 ± 3.4 postoperatively. CONCLUSIONS: For adolescents with flatfoot, calcaneal Z osteotomy combined with subtalar arthroereisis provided satisfactory results. LEVEL OF EVIDENCE: Level IV, retrospective case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/27402620/Calcaneal_Z_Lengthening_Osteotomy_Combined_With_Subtalar_Arthroereisis_for_Severe_Adolescent_Flexible_Flatfoot_Reconstruction_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100716658975?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -