Early graft failure in lateral column lengthening

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Foot and Ankle Surgery

Background:

• Planovalgus foot deformity is a common condition in children requiring surgical correction.
• Lateral column lengthening is a surgical technique used to address this deformity.
• Different surgical approaches exist, including calcaneal neck lengthening and calcaneocuboid joint fusion.

Purpose of the Study:

• To compare the durability of lateral column lengthening techniques for planovalgus foot deformities in children.
• To evaluate the incidence of graft collapse and loss of correction associated with each surgical method.

Main Methods:

• Retrospective review of 130 pediatric feet (96 children) undergoing lateral column lengthening.
• Categorization of procedures into calcaneal neck lengthening (allografts and autografts) and calcaneocuboid joint lengthening with arthrodesis (allografts and autografts).
• Radiographic evaluation before and after surgery, and at follow-up, to assess correction, graft integrity, and collapse.

Main Results:

• Seventeen of 58 calcaneocuboid joint allografts (29.3%) demonstrated collapse between 0.3 and 1.3 years post-surgery.
• No collapse was observed in any of the 69 intracalcaneal grafts (allografts and autografts).
• No collapse occurred in the 3 calcaneocuboid autografts.

Conclusions:

• Lateral column lengthening through the neck of the calcaneus appears to provide a more durable correction for planovalgus foot deformities compared to calcaneocuboid joint fusion.
• Autografts and allografts used in calcaneal neck lengthening demonstrated superior stability.
• Calcaneocuboid joint fusion with allografts showed a significant rate of collapse, indicating potential long-term instability.