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T D Chi1, B C Toolan, B J Sangeorzan
1Department of Orthopaedics, Harborview Medical Center, School of Medicine, University of Washington, Seattle 98104, USA.
Clinical Orthopaedics and Related Research
|January 11, 2000
Summary
Surgical treatments for adult acquired flatfoot, including medial and lateral column procedures, effectively reduced pain and improved foot alignment. These methods offer successful deformity correction without compromising essential foot joints.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Reconstruction
Background:
- Adult acquired flatfoot is often caused by posterior tibialis tendon insufficiency.
- Surgical intervention is frequently required to correct the resulting deformities.
Purpose of the Study:
- To review the outcomes of medial column stabilization, lateral column lengthening, and combined procedures for adult acquired flatfoot.
- To evaluate the effectiveness of these surgical techniques in pain reduction and deformity correction.
Main Methods:
- Retrospective review of 65 feet treated with surgical procedures.
- Procedures included flexor digitorum longus tendon transfer, tendoachilles lengthening or gastrocnemius recession.
- Specific bony procedures: medial column fusion, lateral column lengthening, or combined techniques based on deformity type.
Main Results:
- Significant pain reduction or complete pain relief was observed in 88% (lateral column lengthening), 80% (medial column stabilization), and 88% (combined procedures) of patients.
- Radiographic improvements were noted in the lateral talar first metatarsal angle and anteroposterior talonavicular coverage angle across all groups.
- Average improvement in lateral talar first metatarsal angle: 16-24 degrees; average improvement in anteroposterior talonavicular coverage angle: 10-14 degrees.
Conclusions:
- Medial column stabilization, lateral column lengthening, and combined procedures are effective in treating adult acquired flatfoot secondary to posterior tibialis tendon insufficiency.
- These surgical techniques successfully correct complex foot deformities while preserving the integrity of the hindfoot and midfoot joints.
