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Calcaneal Lengthening Osteotomy for the Symptomatic Flexible Flatfoot in Adults  

Choi, Hong Joon (Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine)
Cho, Jae Ho (Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine)
Wang, Bae Gun (Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine)
Publication Information
Journal of Korean Foot and Ankle Society / v.17, no.2, 2013 , pp. 115-120 More about this Journal
Abstract
Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.
Keywords
Flatfoot; Adult flexible; Calcaneal lengthening osteotomy;
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