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Effect of Lateral Column Lengthening on Subtalar Motion in a Cadaveric Model
Mitchell C Harris1, Brittany N Hedrick2, Jacob R Zide3
1Tripler Army Medical Center, Honolulu, HI, USA.
Foot & Ankle International
|November 18, 2020
Summary
Lateral column lengthening (LCL) for flatfoot reconstruction does not significantly alter subtalar motion. Postoperative stiffness may stem from soft tissue scarring, not joint anatomy changes.
Area of Science:
- Orthopedic surgery
- Foot and ankle biomechanics
- Pediatric reconstructive surgery
Background:
- Lateral column lengthening (LCL) via calcaneal neck osteotomy is crucial for correcting flexible planovalgus deformities in children.
- Concerns exist regarding the impact of this intra-articular osteotomy on subtalar joint motion.
Purpose of the Study:
- To quantitatively assess the effect of LCL on subtalar joint motion using biomechanical analysis.
Main Methods:
- 14 fresh-frozen cadaveric feet underwent 3D motion capture and materials testing system analysis.
- Subtalar motion (abduction/adduction, supination/pronation, plantarflexion/dorsiflexion) was measured before and after LCL with a calcaneal neck osteotomy.
- A paired t-test compared pre- and post-osteotomy motion under a 5 Nm torque.
Main Results:
- No statistically significant differences were found in subtalar abduction/adduction (P=.48), supination/pronation (P=.31), or plantarflexion/dorsiflexion (P=.10) after LCL.
- The mean changes in motion were minimal and within the margin of error.
Conclusions:
- LCL, as performed in this cadaveric study, does not significantly alter subtalar joint biomechanics.
- Clinical observations of reduced subtalar motion post-LCL may be attributable to soft tissue scarring rather than intrinsic joint changes.
