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[Evans lateral lengthening calcaneal osteotomy in treatment of talocalcaneal coalition with hindfoot valgus deformity].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Feb 15; 34(2):173-178.ZX

Abstract

Objective

To investigate the effectiveness of the Evans lateral lengthening calcaneal osteotomy (E-LLCOT) in treatment of talocalcaneal coalition (TCC) with hindfoot valgus deformity.

Methods

Between January 2014 and October 2017, 10 patients (13 feet) of TCC with hindfoot valgus deformities underwent E-LLCOTs. There were 6 males (8 feet) and 4 females (5 feet) with an age of 13-18 years (mean, 15.8 years). The disease duration was 10-14 months (mean, 11.5 months). The foot deformity was characterized by hindfoot valgus, forefoot abduction, and collapse of the medial arch. Pain site was the tarsal sinus in 4 feet, TCC in 5 feet, and ankle joint in 4 feet. There were tightness of the gastrocnemius in 3 cases (4 feet) and Achilles tendon in 7 cases (9 feet) on Silverskiold test. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 46.54±9.08 and visual analogue scale (VAS) score was 6.54±0.88 after walking 1 kilometer. The AOFAS ankle-hindfoot score and VAS score were adopted to evaluate the postoperative function of the foot. The talar-first metatarsal angle (T1MT), talonavicular coverage angle (TCA), talar-horizontal angle (TH), calcaneal pitch angle (CP), and heel valgus angle (HV) were measured after operation.

Results

All incisions healed by first intention. All patients were followed up 12-30 months (mean, 18 months). At last follow-up, the AOFAS ankle-hindfoot score and VAS score were 90.70±6.75 and 1.85±0.90, respectively, showing significant differences when compared with preoperative scores ( t=-23.380, P=0.000; t=35.218, P=0.000). X-ray films showed that the osteotomy healed at 2-4 months (mean, 3 months) after operation. At last follow-up, the T1MT, TCA, TH, and HV were significantly lower than preoperative ones ( P<0.05), and the CP was significantly higher than preoperative one ( P<0.05). During the follow-up, the pain did not relieve obviously in 1 patient (1 foot), and the cutaneous branch of the sural nerve injured in 1 patient (1 foot).

Conclusion

For TCC with severe hindfoot valgus deformity, E-LLCOT can effectively correct deformity and relieve pain.

Authors+Show Affiliations

Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou Henan, 450052, P.R.China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

32030947

Citation

Shang, Lin, et al. "[Evans Lateral Lengthening Calcaneal Osteotomy in Treatment of Talocalcaneal Coalition With Hindfoot Valgus Deformity]." Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, vol. 34, no. 2, 2020, pp. 173-178.
Shang L, Wang X, Wang A, et al. [Evans lateral lengthening calcaneal osteotomy in treatment of talocalcaneal coalition with hindfoot valgus deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020;34(2):173-178.
Shang, L., Wang, X., Wang, A., Jia, G., Li, Q., Zhang, X., Ma, F., & Wang, Y. (2020). [Evans lateral lengthening calcaneal osteotomy in treatment of talocalcaneal coalition with hindfoot valgus deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi = Zhongguo Xiufu Chongjian Waike Zazhi = Chinese Journal of Reparative and Reconstructive Surgery, 34(2), 173-178. https://doi.org/10.7507/1002-1892.201907065
Shang L, et al. [Evans Lateral Lengthening Calcaneal Osteotomy in Treatment of Talocalcaneal Coalition With Hindfoot Valgus Deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Feb 15;34(2):173-178. PubMed PMID: 32030947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Evans lateral lengthening calcaneal osteotomy in treatment of talocalcaneal coalition with hindfoot valgus deformity]. AU - Shang,Lin, AU - Wang,Xiangyu, AU - Wang,Aiguo, AU - Jia,Guanghui, AU - Li,Qi, AU - Zhang,Xiaolong, AU - Ma,Fuqiang, AU - Wang,Yalei, PY - 2020/2/8/entrez PY - 2020/2/8/pubmed PY - 2020/2/29/medline KW - Evans lateral lengthening calcaneal osteotomy KW - Talocalcaneal coalition KW - foot KW - valgus deformity SP - 173 EP - 178 JF - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery JO - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi VL - 34 IS - 2 N2 - Objective: To investigate the effectiveness of the Evans lateral lengthening calcaneal osteotomy (E-LLCOT) in treatment of talocalcaneal coalition (TCC) with hindfoot valgus deformity. Methods: Between January 2014 and October 2017, 10 patients (13 feet) of TCC with hindfoot valgus deformities underwent E-LLCOTs. There were 6 males (8 feet) and 4 females (5 feet) with an age of 13-18 years (mean, 15.8 years). The disease duration was 10-14 months (mean, 11.5 months). The foot deformity was characterized by hindfoot valgus, forefoot abduction, and collapse of the medial arch. Pain site was the tarsal sinus in 4 feet, TCC in 5 feet, and ankle joint in 4 feet. There were tightness of the gastrocnemius in 3 cases (4 feet) and Achilles tendon in 7 cases (9 feet) on Silverskiold test. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 46.54±9.08 and visual analogue scale (VAS) score was 6.54±0.88 after walking 1 kilometer. The AOFAS ankle-hindfoot score and VAS score were adopted to evaluate the postoperative function of the foot. The talar-first metatarsal angle (T1MT), talonavicular coverage angle (TCA), talar-horizontal angle (TH), calcaneal pitch angle (CP), and heel valgus angle (HV) were measured after operation. Results: All incisions healed by first intention. All patients were followed up 12-30 months (mean, 18 months). At last follow-up, the AOFAS ankle-hindfoot score and VAS score were 90.70±6.75 and 1.85±0.90, respectively, showing significant differences when compared with preoperative scores ( t=-23.380, P=0.000; t=35.218, P=0.000). X-ray films showed that the osteotomy healed at 2-4 months (mean, 3 months) after operation. At last follow-up, the T1MT, TCA, TH, and HV were significantly lower than preoperative ones ( P<0.05), and the CP was significantly higher than preoperative one ( P<0.05). During the follow-up, the pain did not relieve obviously in 1 patient (1 foot), and the cutaneous branch of the sural nerve injured in 1 patient (1 foot). Conclusion: For TCC with severe hindfoot valgus deformity, E-LLCOT can effectively correct deformity and relieve pain. SN - 1002-1892 UR - https://www.unboundmedicine.com/medline/citation/32030947/[Evans_lateral_lengthening_calcaneal_osteotomy_in_treatment_of_talocalcaneal_coalition_with_hindfoot_valgus_deformity] DB - PRIME DP - Unbound Medicine ER -