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Lateral column lengthening using allograft interposition and cervical plate fixation.

Terrence M Philbin1, Christopher Pokabla, Gregory C Berlet

  • 1Orthopedic Foot & Ankle Center, Columbus, Ohio 43231, USA. philbsgoirish@wowway.com

Foot & Ankle Specialist
|October 15, 2009
PubMed
Summary

Lateral column lengthening with allograft bone and cervical plate fixation effectively treats adult-acquired pes planovalgus. This method shows high union rates and improved patient outcomes without donor site morbidity.

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Reconstruction
  • Biomaterials in Orthopedics

Background:

  • Stage II adult-acquired pes planovalgus deformity requires effective surgical correction.
  • Lateral column lengthening is a recognized surgical technique for this condition.
  • Evaluating allograft use and cervical plate fixation is crucial for optimizing outcomes.

Purpose of the Study:

  • To assess the union rate of lateral column lengthening using allograft bone.
  • To evaluate the efficacy of cervical plate fixation in stabilizing the osteotomy.
  • To determine clinical and radiographic outcomes in patients with pes planovalgus.

Main Methods:

  • Retrospective review of 28 feet in 26 patients with stage II pes planovalgus.
  • Lateral column lengthening utilized tricortical iliac crest allograft stabilized with a cervical plate.

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  • Preoperative and postoperative assessments included modified AOFAS scores, SF-12, and radiographic talonavicular coverage angle.

    • Main Results:

    • Significant improvement in modified AOFAS Ankle-Hindfoot Scale scores (45.6) and pain subscores (25.0) at 9-month follow-up.
    • High graft incorporation rate (all but one case) with an average union time of 10.06 weeks.
    • Complications included hardware removal, one nonunion, graft penetration, and calcaneocuboid arthritis.

    Conclusions:

    • Lateral column lengthening with allograft and cervical plate fixation is a viable treatment for acquired pes planovalgus.
    • Allograft bone avoids donor site morbidity and does not increase nonunion rates.
    • Cervical plate fixation facilitates union and is associated with high patient satisfaction.