Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results
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 d...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2024-11, Vol.35 (1), p.15, Article 15 |
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| creator | Afifi, Ahmed Osman, Sari M. Al-Abri, Al-Munqith Hegazy, Mohammed Heiba Shaheen, Ayman Mansour, Ayman Galal, Sherif |
| description | 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. |
| doi_str_mv | 10.1007/s00590-024-04139-7 |
| format | Article |
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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.</description><identifier>ISSN: 1432-1068</identifier><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-024-04139-7</identifier><identifier>PMID: 39567389</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Adolescent ; Adult ; Ankle ; Bone Lengthening - methods ; Bone Transplantation - methods ; Calcaneus - diagnostic imaging ; Calcaneus - surgery ; Female ; Fibula - transplantation ; Flatfoot - diagnostic imaging ; Flatfoot - surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Osteotomy - methods ; Radiography ; Retrospective Studies ; Skin & tissue grafts ; Surgical Orthopedics ; Traumatic Surgery ; Treatment Outcome ; Young Adult</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2024-11, Vol.35 (1), p.15, Article 15</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-7d31da82da6afc77566c92373be79bb200252aebb661afafdc8856d72e0d18193</cites><orcidid>0000-0001-6637-8426 ; 0000-0002-2120-0621</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-024-04139-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-024-04139-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39567389$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Afifi, Ahmed</creatorcontrib><creatorcontrib>Osman, Sari M.</creatorcontrib><creatorcontrib>Al-Abri, Al-Munqith</creatorcontrib><creatorcontrib>Hegazy, Mohammed Heiba</creatorcontrib><creatorcontrib>Shaheen, Ayman</creatorcontrib><creatorcontrib>Mansour, Ayman</creatorcontrib><creatorcontrib>Galal, Sherif</creatorcontrib><title>Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Ankle</subject><subject>Bone Lengthening - methods</subject><subject>Bone Transplantation - methods</subject><subject>Calcaneus - diagnostic imaging</subject><subject>Calcaneus - surgery</subject><subject>Female</subject><subject>Fibula - transplantation</subject><subject>Flatfoot - diagnostic imaging</subject><subject>Flatfoot - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Osteotomy - methods</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Skin & tissue grafts</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1432-1068</issn><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-PFCEQxYnRuOvqF_BgSLx4aS2gaRpvZqLuJpt40TOhu4uRDQ0j0Ilz94PL7qx_4sETRfi9V1Q9Qp4zeM0A1JsCIDV0wPsOeiZ0px6Qc9YL3jEYxod_1WfkSSk3AExqJh-TM6HloMSoz8mPnQ2zjWgDDRj39StGH_c0lYqppvVIt3J794fig62YG-f8tAWb6T5bV6mPtIlozWjrirHS5KgL-N1PAVthq0up0gVdyquvx7f0kDH41UebjzRj2UItT8kjZ0PBZ_fnBfny4f3n3WV3_enj1e7ddTdzOdROLYItduSLHayblZLDMGsulJhQ6WniAFxyi9M0DMw665Z5HOWwKI6wsJFpcUFenXwPOX3bsFSz-jJjCG0BaStGMMF6rQXvG_ryH_QmbTm2391R0EsAaBQ_UXNOpWR05pD92iYzDMxtRuaUkWkZmbuMjGqiF_fW27Ti8lvyK5QGiBNQ2lPcY_7T-z-2PwFb4Z-B</recordid><startdate>20241121</startdate><enddate>20241121</enddate><creator>Afifi, Ahmed</creator><creator>Osman, Sari M.</creator><creator>Al-Abri, Al-Munqith</creator><creator>Hegazy, Mohammed Heiba</creator><creator>Shaheen, Ayman</creator><creator>Mansour, Ayman</creator><creator>Galal, Sherif</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6637-8426</orcidid><orcidid>https://orcid.org/0000-0002-2120-0621</orcidid></search><sort><creationdate>20241121</creationdate><title>Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results</title><author>Afifi, Ahmed ; Osman, Sari M. ; Al-Abri, Al-Munqith ; Hegazy, Mohammed Heiba ; Shaheen, Ayman ; Mansour, Ayman ; Galal, Sherif</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-7d31da82da6afc77566c92373be79bb200252aebb661afafdc8856d72e0d18193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Ankle</topic><topic>Bone Lengthening - methods</topic><topic>Bone Transplantation - methods</topic><topic>Calcaneus - diagnostic imaging</topic><topic>Calcaneus - surgery</topic><topic>Female</topic><topic>Fibula - transplantation</topic><topic>Flatfoot - diagnostic imaging</topic><topic>Flatfoot - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Osteotomy - methods</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Skin & tissue grafts</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Afifi, Ahmed</creatorcontrib><creatorcontrib>Osman, Sari M.</creatorcontrib><creatorcontrib>Al-Abri, Al-Munqith</creatorcontrib><creatorcontrib>Hegazy, Mohammed Heiba</creatorcontrib><creatorcontrib>Shaheen, Ayman</creatorcontrib><creatorcontrib>Mansour, Ayman</creatorcontrib><creatorcontrib>Galal, Sherif</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Afifi, Ahmed</au><au>Osman, Sari M.</au><au>Al-Abri, Al-Munqith</au><au>Hegazy, Mohammed Heiba</au><au>Shaheen, Ayman</au><au>Mansour, Ayman</au><au>Galal, Sherif</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2024-11-21</date><risdate>2024</risdate><volume>35</volume><issue>1</issue><spage>15</spage><pages>15-</pages><artnum>15</artnum><issn>1432-1068</issn><issn>1633-8065</issn><eissn>1432-1068</eissn><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.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>39567389</pmid><doi>10.1007/s00590-024-04139-7</doi><orcidid>https://orcid.org/0000-0001-6637-8426</orcidid><orcidid>https://orcid.org/0000-0002-2120-0621</orcidid></addata></record> |
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| subjects | Adolescent Adult Ankle Bone Lengthening - methods Bone Transplantation - methods Calcaneus - diagnostic imaging Calcaneus - surgery Female Fibula - transplantation Flatfoot - diagnostic imaging Flatfoot - surgery Humans Male Medicine Medicine & Public Health Original Article Osteotomy - methods Radiography Retrospective Studies Skin & tissue grafts Surgical Orthopedics Traumatic Surgery Treatment Outcome Young Adult |
| title | Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results |
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