Adult Acquired Flexible Flatfoot Deformity After Failure of Conservative Treatment
Conditions
Brief summary
To assess radiological and functional outcomes of modified extra-articular lateral column lengthening procedure for correction of adult acquired flexible flatfoot deformity
Detailed description
Measurement of 1. Calcencal pitch : This angle is formed on a weight-bearing lateral foot radiograph between the calcaneal Inclination axis and the supporting horizontal surface(10), normal ranges of between 10-25° and 20-30 have Been proposed(11) 2. Meary's angle: It is the angle between a line drawn along the longitudinal axis of the talus (mid-talar axis) and the first metatarsal (first metatarsal axis) , typically', Meary's angle is 0°, with abnormal values considered angle \>4° convex upward: pes cavus , angle \<-4 convex downward: pes planus, It can be used to classify the severity of deformity 3. lateral talocalceneal angle : the angle between the calcaneal inclination axis and the mid-talar axis , The lateral talocalcaneal angle should normally measure between 25 and 40°, \>40° diagnoses flatfoot deformity(12) 4. Talonavicular coverage angle: it is the medial angle between ( talar head articular surface and Proximal navicular articular surface) ,Interpreting the talonavicular coverage angle (13)Normal: \<7,Adult Acquired flatfoot disease: \>7°
Interventions
PROCEDUREExtra-articular Lateral Column Lengthening Procedure
Lateral column lengthening (LCL), originally described by Evans, is an established procedure to correct stage II adult acquired flatfoot deformity (AAFD). However, the relative position between the facets is violated, and other problems may include nonunion, malunion, and calcaneocuboid (CC) joint subluxation. Herein, we report a modified extra-articular technique of LCL with hockey-stick osteotomy, which preserves the subtalar joint as a whole, increases bony apposition to enhance healing ability, and preserves the insertion of the calcaneofibular ligament to stabilize the posterior fragment to promote adduction of the forefoot
Sponsors
Assiut University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
\- 1) Age : adult ( age above 16 years old and below 65 years old 2\) symptomatic flexible flat foot after failure of Conservative treatment
Exclusion criteria
* 1- Age: (<16,>65) years old 2 -Previous foot surgery 3- autoimmune disease * 4 Uncontrolled blood sugar 5- Osteoprotic patient 6- Infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiological outcome & by standard erect plain x ray after 3 months | 3 months after the surgery | Measurement of 1. Calcencal pitch : this angle is formed on a weight-bearing lateral foot radiograph between the calcaneal Inclination axis and the supporting horizontal surface , correction angle needed ≈ 15-25°. 2. Meary's angle: It is the angle between a line drawn along the longitudinal axis of the talus (mid-talar axis) and the first metatarsal (first metatarsal axis) , correction angle needed ≈ 0-1°. 3. lateral talocalceneal angle : the angle between the calcaneal inclination axis and the mid-talar axis correction angle ≈ 25 and 40° . 4. Talonavicular coverage angle: it is the medial angle between ( talar head articular surface and Proximal navicular articular surface |
Secondary
| Measure | Time frame |
|---|---|
| clinical outcome by American orthopedic foot and ankle score (hindfoot | 6 months after the surgery when the patient restore his life activities maximally |
Countries
Egypt
Contacts
Primary ContactHosam Eldeen Kamal Mohamed, Resident
Outcome results
None listed