Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results.

IF 1.4 Q3 ORTHOPEDICS

European Journal of Orthopaedic Surgery and Traumatology Pub Date : 2024-11-21 DOI:10.1007/s00590-024-04139-7

Ahmed Afifi, Sari M Osman, Al-Munqith Al-Abri, Mohammed Heiba Hegazy, Ayman Shaheen, Ayman Mansour, Sherif Galal

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引用次数: 0

Abstract

Purpose: Flexible flatfoot deformity is quite common among adolescents. This study aimed to report the preliminary results of calcaneal lengthening osteotomy using a fibular bone graft.

Methods: This single-center, retrospective study included 28 patients (28 feet) with symptomatic flexible flatfoot deformity. The deformity was corrected with calcaneal lengthening osteotomy using an ipsilateral fibular graft. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score at the final follow-up was selected as the primary outcome measure. Radiographic outcomes included the anteroposterior talo-first metatarsal (AP talo-MT1) angle, the lateral talo-first metatarsal (LAT talo-MT1) angle, the lateral calcaneal pitch (LCP), and the Goldberg scoring system (GSS) for fibular graft incorporation. The visual analogue scale (VAS) was used to assess pain over the ipsilateral fibula donor site.

Results: The AOFAS ankle hindfoot score improved from a mean of 53.7 ± 22.4 to a mean of 81.1 ± 19.8, the AP talo-MT1 angle improved from a mean of 24.1° ± 15.6 to a mean of 12.9° ± 7.3, the LAT talo-MT1 angle improved from a mean of 22.3° ± 3.2 to a mean of 7.9° ± 2.3, and the LCP improved from a mean of 10.1° ± 7 to a mean of 24.4° ± 9.1. The GSS was seven points in all patients, which indicated complete radiographic union with an excellent reorganization of the fibular bone graft. The VAS for pain over the ipsilateral fibula donor site was zero at the final follow-up.

Conclusion: The fibular bone autograft achieved excellent incorporation when used in calcaneal lengthening osteotomy with good improvement in the clinical and radiographic outcomes in patients with symptomatic flexible flatfoot deformity.

Level of evidence: III, Therapeutic study.

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使用同侧腓骨移植的腓骨延长截骨术治疗柔性扁平足畸形：初步结果。

目的：灵活的扁平足畸形在青少年中十分常见。本研究旨在报告使用腓骨移植进行小腿骨延长截骨术的初步结果：这项单中心回顾性研究共纳入了 28 名有症状的灵活扁平足畸形患者（28 只脚）。采用同侧腓骨移植的小方腿延长截骨术矫正了畸形。最终随访时的美国矫形足踝协会（AOFAS）踝关节后足评分被选为主要结果测量指标。影像学结果包括距第一跖骨前柱角（AP talo-MT1）、距第一跖骨外侧角（LAT talo-MT1）、小腿外侧间距（LCP）和腓骨移植物结合的戈德堡评分系统（GSS）。视觉模拟量表（VAS）用于评估同侧腓骨供体部位的疼痛：结果：AOFAS踝关节后足评分从平均值（53.7 ± 22.4）提高到平均值（81.1 ± 19.8），AP talo-MT1角度从平均值（24.1° ± 15.6）提高到平均值（12.9° ± 7.3），LAT talo-MT1角度从平均值（22.3° ± 3.2）提高到平均值（7.9° ± 2.3），LCP从平均值（10.1° ± 7）提高到平均值（24.4° ± 9.1）。所有患者的 GSS 均为 7 分，这表明腓骨植骨在良好的重组下实现了完全的放射学结合。最后随访时，同侧腓骨供体部位疼痛的 VAS 为零：结论：腓骨自体移植在小腿骨延长截骨术中实现了极佳的结合，对有症状的柔性扁平足畸形患者的临床和影像学结果都有很好的改善：III级，治疗性研究。

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来源期刊

European Journal of Orthopaedic Surgery and Traumatology 医学-整形外科

CiteScore

3.00

自引率

5.90%

发文量

265

审稿时长

3-8 weeks

期刊介绍： The European Journal of Orthopaedic Surgery and Traumatology (EJOST) aims to publish high quality Orthopedic scientific work. The objective of our journal is to disseminate meaningful, impactful, clinically relevant work from each and every region of the world, that has the potential to change and or inform clinical practice.