Reconstruction of the interosseus talocalcaneal ligament in progressive collapsing foot deformity: A review of the literature and description of a novel surgical technique

IF 1.3 4区医学 Q2 Medicine

Journal of Foot & Ankle Surgery Pub Date : 2025-07-07 DOI:10.1053/j.jfas.2025.06.008

Francois Lintz MD, PhD , Enrico Pozzessere MD , Carla Carfì MD , Kanyakorn Riewruja MD , Wolfram Grün MD , Canon Cornelius MD , Scott J Ellis MD , Cesar de Cesar Netto MD, PhD

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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.

查看原文本刊更多论文

进行性塌陷足畸形的骨间距跟韧带重建：文献综述和一种新手术技术的描述。

背景：骨间距跟韧带（ITCL）是距下关节的关键稳定剂，对防止距跟散至关重要。其衰减与进行性塌陷足畸形（PCFD）的发病机制密切相关。因此，ITCL的解剖重建可以为治疗柔性（1期）PCFD提供希望，旨在恢复距下关节的稳定性并防止畸形进展。本研究的目的是报告现有的ITCL重建技术，并提出一种新的PCFD方法。研究设计：当前概念和技术说明方法：对ITCL重建的现有文献进行集中的当前概念回顾，以确定机会和现有差距。随后，我们介绍了一种新的手术技术，利用同种异体半腱肌移植重建ITCL、弹簧韧带和浅三角韧带复合体。使用专用的定位指南以确保精确识别和准确放置韧带附着部位。结果：目前的文献主要讨论距下不稳定与慢性外侧踝关节不稳定（CLAI）相关的ITCL重建。然而，没有先前的方法明确地解决ITCL重建管理PCFD，这在文献中构成了一个重大的空白。我们描述了一种新的外科技术来解决柔性（1期）PCFD的ITCL重建。结论：ITCL重建是保守治疗伴有肱骨周围半脱位（D级）的柔性PCFD的合理下一步，以避免关节牺牲手术的需要。提出了一种新的外科手术方法。需要进一步的临床研究来评估ITCL重建的影像学和患者报告的结果。证据级别：V级：审查5级证据和专家意见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY

CiteScore

2.30

自引率

7.70%

发文量

234

审稿时长

29.8 weeks

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.