Reconstruction of the interosseus talocalcaneal ligament in progressive collapsing foot deformity: A review of the literature and description of a novel surgical technique.
Francois Lintz, Enrico Pozzessere, Carla Carfì, Kanyakorn Riewruja, Wolfram Grün, Canon Cornelius, Scott J Ellis, Cesar de Cesar Netto
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引用次数: 0
Abstract
Background: The Interosseous Talo-Calcaneal Ligament (ITCL) is a key stabilizer of the subtalar joint, essential in preventing talo-calcaneal divergence. Its attenuation significantly contributes to the pathogenesis of Progressive Collapsing Foot Deformity (PCFD). Thus, anatomical reconstruction of the ITCL could offer promise in treating flexible (Stage 1) PCFD, aiming to restore subtalar joint stability and prevent deformity progression. The aim of the present work was to report existing ITCL reconstruction techniques and present a novel approach in PCFD.
Study design: Current concept and technical note METHODS: A focused current concepts review of existing literature on ITCL reconstruction was performed to identify opportunities and existing gaps. Subsequently, we introduced a novel surgical technique for anatomically reconstructing the ITCL, spring ligament, and superficial deltoid ligament complex using a semitendinosus allograft. Dedicated targeting guides were employed to ensure precise identification and accurate placement of ligament attachment sites.
Results: Current literature primarily discusses ITCL reconstruction within the context of subtalar instability associated with Chronic Lateral Ankle Instability (CLAI). However, no prior method has explicitly addressed ITCL reconstruction for managing PCFD, which constitutes a significant gap in the literature. We describe a novel surgical technique to address ITCL reconstruction in flexible (Stage 1) PCFD.
Conclusion: ITCL reconstruction the logical next step in conservative treatment of flexible PCFD with peritalar subluxation (class D), to circumvent the need for joint-sacrificing procedures. A novel surgical procedure is presented. Further clinical studies are warranted to evaluate the radiographic and patient-reported outcomes of ITCL reconstruction.
期刊介绍:
The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.