Subtalar Arthroereisis as an Adjunct Procedure Improves Forefoot Abduction in Stage IIb Adult-Acquired Flatfoot Deformity.


Journal

Foot & ankle specialist
ISSN: 1938-7636
Titre abrégé: Foot Ankle Spec
Pays: United States
ID NLM: 101473598

Informations de publication

Date de publication:
Jun 2022
Historique:
pubmed: 25 8 2020
medline: 22 6 2022
entrez: 25 8 2020
Statut: ppublish

Résumé

Our aims were (a) to determine whether subtalar arthroereisis (STA) as adjunct procedure improved radiographic correction of stage IIb adult-acquired flexible flatfoot deformity (AAFD); (b) to assess the STA-related complication rate. A retrospective analysis of 22 feet (21 patients) diagnosed with stage IIb AAFD treated by medializing calcaneal osteotomy (MCO), flexor digitorum longus (FDL) transfer, spring ligament (SL) repair with or without Cotton osteotomy and with or without STA in a single institution was carried out. Seven measurements were recorded on pre- and postoperative (minimum 24 weeks) radiographs by 2 observers and repeated twice by 1 observer. Inter- and intraobserver reliabilities were assessed. The association of demographic (gender, side, age, body mass index) and surgical variables (Cotton, STA) with radiographic change was tested with univariate analysis followed by a multivariable regression model. Excellent inter- and intraobserver reliabilities were demonstrated for all measurements (intraclass correlation coefficient range, 0.75-0.99). Gender, side, Cotton osteotomy, and STA were included in the multivariable analysis. Regression showed that STA was the only predictor of change in talonavicular coverage angle (TNCA) ( In this series, STA as an adjunct procedure to MCO, FDL transfer, SL repair in the treatment of stage IIb AAFD led to improvement in correction of forefoot abduction. STA-related complication and removal rates were 33%. Level IV: Retrospective cohort study.

Sections du résumé

BACKGROUND BACKGROUND
Our aims were (a) to determine whether subtalar arthroereisis (STA) as adjunct procedure improved radiographic correction of stage IIb adult-acquired flexible flatfoot deformity (AAFD); (b) to assess the STA-related complication rate.
METHODS METHODS
A retrospective analysis of 22 feet (21 patients) diagnosed with stage IIb AAFD treated by medializing calcaneal osteotomy (MCO), flexor digitorum longus (FDL) transfer, spring ligament (SL) repair with or without Cotton osteotomy and with or without STA in a single institution was carried out. Seven measurements were recorded on pre- and postoperative (minimum 24 weeks) radiographs by 2 observers and repeated twice by 1 observer. Inter- and intraobserver reliabilities were assessed. The association of demographic (gender, side, age, body mass index) and surgical variables (Cotton, STA) with radiographic change was tested with univariate analysis followed by a multivariable regression model.
RESULTS RESULTS
Excellent inter- and intraobserver reliabilities were demonstrated for all measurements (intraclass correlation coefficient range, 0.75-0.99). Gender, side, Cotton osteotomy, and STA were included in the multivariable analysis. Regression showed that STA was the only predictor of change in talonavicular coverage angle (TNCA) (
CONCLUSION CONCLUSIONS
In this series, STA as an adjunct procedure to MCO, FDL transfer, SL repair in the treatment of stage IIb AAFD led to improvement in correction of forefoot abduction. STA-related complication and removal rates were 33%.
LEVELS OF EVIDENCE UNASSIGNED
Level IV: Retrospective cohort study.

Identifiants

pubmed: 32830576
doi: 10.1177/1938640020951031
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

209-220

Auteurs

Alessio Bernasconi (A)

Department of Public Health, Trauma and Orthopaedics, University of Naples Federico II, Naples, Italy.
Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Miltiadis Argyropoulos (M)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Shelain Patel (S)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Yaser Ghani (Y)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Nicholas Cullen (N)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Dishan Singh (D)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

Matthew Welck (M)

Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, UK.

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