Lateral Column Lengthening for Revision Triple and Double Arthrodesis and Severe End-Stage Flatfoot Deformity

J Foot Ankle Surg. 2019 May;58(3):577-580. doi: 10.1053/j.jfas.2018.08.029. Epub 2019 Feb 8.

Abstract

Few options exist for the treatment of revision and severe cases of end-stage flatfoot deformity. Triple arthrodesis or medial-approach double arthrodesis have been the standard but often do not provide enough correction of the deformity. Lateral column lengthening is a powerful procedure performed either with an Evans calcaneal osteotomy or calcaneocuboid distraction arthrodesis that can be used as an adjunct in realigning the flatfoot. We performed a retrospective radiographic review and looked at 11 consecutive cases of patients who underwent hindfoot arthrodesis with a lateral column lengthening procedure. We matched these patients with 11 control patients who underwent isolated medial-approach double arthrodesis. For the patients who underwent a lateral column lengthening procedure, we found a significant improvement in calcaneal inclination angle (p = .001) and greater correction in talar declination angle, cuboid abduction angle, and talocalcaneal angle when compared with the control group. Lateral column lengthening is a useful adjunct to hindfoot arthrodesis in the correction of revision and severe end-stage flatfoot deformity.

Keywords: Level of Clinical Evidence: 4; dysfunction; medial; osteotomy; posterior; tendon; tibial.

MeSH terms

  • Adult
  • Aged
  • Arthrodesis / methods*
  • Case-Control Studies
  • Female
  • Flatfoot / diagnostic imaging
  • Flatfoot / surgery*
  • Humans
  • Male
  • Middle Aged
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Young Adult