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A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening.
Foot Ankle Spec. 2020 May 05 [Online ahead of print]FA

Abstract

Background:

Lateral column lengthening (LCL) is a commonly performed procedure for patients with stage II adult-acquired flatfoot deformity (AAFD) to correct forefoot abduction. This procedure is frequently completed concomitantly with both soft-tissue and bony procedures, including a medial slide calcaneal osteotomy to further reduce hindfoot valgus. The purpose of this study is to investigate and identify the radiographic outcomes of a modified step-cut LCL utilized as an alternative approach for correction of stage II AAFD.

Methods:

A retrospective radiographic review was performed on 15 feet in 14 patients who underwent correction of stage II AAFD using a step-cut LCL between August 2009 and January 2012. Two independent examiners utilizing 6 radiographic parameters evaluated preoperative and postoperative weight-bearing radiographs of the foot.

Results:

At a mean follow-up of 13.4 (range 12-16) weeks, weight-bearing radiographs demonstrated a significant median decrease in the lateral talometatarsal angle of 14.4° (P < .001), lateral talocalcaneal angle of 7° (P < .001), anteroposterior talometatarsal angle of 14.5° (P < .001), anteroposterior talocalcaneal angle of 5.5° (P < .001), and talonavicular coverage angle of 26.5° (P < .001). Additionally, a significant median increase in calcaneal pitch of 8.5° (P < .001) was noted.

Conclusion:

This study demonstrates statistically significant improvement of radiographic outcomes with use of a modified step-cut LCL as an alternative approach for correction of stage II AAFD. Levels of Evidence: Level IV: Retrospective case series.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (KW, KB). Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey (EF). Orthopedic and Sports Medicine Associates, Green Bay, Wisconsin (GK).Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (KW, KB). Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey (EF). Orthopedic and Sports Medicine Associates, Green Bay, Wisconsin (GK).Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (KW, KB). Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey (EF). Orthopedic and Sports Medicine Associates, Green Bay, Wisconsin (GK).Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania (KW, KB). Department of Orthopaedic Surgery, Cooper University Hospital, Camden, New Jersey (EF). Orthopedic and Sports Medicine Associates, Green Bay, Wisconsin (GK).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32370634

Citation

Wapner, Keith, et al. "A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening." Foot & Ankle Specialist, 2020, p. 1938640020919187.
Wapner K, Freeland E, Kirwan G, et al. A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening. Foot Ankle Spec. 2020.
Wapner, K., Freeland, E., Kirwan, G., & Baldwin, K. (2020). A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening. Foot & Ankle Specialist, 1938640020919187. https://doi.org/10.1177/1938640020919187
Wapner K, et al. A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening. Foot Ankle Spec. 2020 May 5;1938640020919187. PubMed PMID: 32370634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening. AU - Wapner,Keith, AU - Freeland,Erik, AU - Kirwan,Gregory, AU - Baldwin,Keith, Y1 - 2020/05/05/ PY - 2020/5/7/entrez KW - calcaneus KW - flatfoot deformity KW - osteotomy KW - posterior tibialis tendon SP - 1938640020919187 EP - 1938640020919187 JF - Foot & ankle specialist JO - Foot Ankle Spec N2 - Background: Lateral column lengthening (LCL) is a commonly performed procedure for patients with stage II adult-acquired flatfoot deformity (AAFD) to correct forefoot abduction. This procedure is frequently completed concomitantly with both soft-tissue and bony procedures, including a medial slide calcaneal osteotomy to further reduce hindfoot valgus. The purpose of this study is to investigate and identify the radiographic outcomes of a modified step-cut LCL utilized as an alternative approach for correction of stage II AAFD. Methods: A retrospective radiographic review was performed on 15 feet in 14 patients who underwent correction of stage II AAFD using a step-cut LCL between August 2009 and January 2012. Two independent examiners utilizing 6 radiographic parameters evaluated preoperative and postoperative weight-bearing radiographs of the foot. Results: At a mean follow-up of 13.4 (range 12-16) weeks, weight-bearing radiographs demonstrated a significant median decrease in the lateral talometatarsal angle of 14.4° (P < .001), lateral talocalcaneal angle of 7° (P < .001), anteroposterior talometatarsal angle of 14.5° (P < .001), anteroposterior talocalcaneal angle of 5.5° (P < .001), and talonavicular coverage angle of 26.5° (P < .001). Additionally, a significant median increase in calcaneal pitch of 8.5° (P < .001) was noted. Conclusion: This study demonstrates statistically significant improvement of radiographic outcomes with use of a modified step-cut LCL as an alternative approach for correction of stage II AAFD. Levels of Evidence: Level IV: Retrospective case series. SN - 1938-7636 UR - https://www.unboundmedicine.com/medline/citation/32370634/A_Retrospective_Radiographic_Evaluation_of_a_Modified_Method_of_Lateral_Column_Lengthening L2 - https://journals.sagepub.com/doi/10.1177/1938640020919187?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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