Morphological variations in the talus and calcaneus in adults with cerebral palsy comparing with and without lateral...

Foot deformities, particularly pes planovalgus, are common in individuals with cerebral palsy, often requiring surgical interventions such as lateral column lengthening (LCL) to improve foot alignment and function. While LCL is a well-established procedure for treating valgus deformities, the long-term effects on bone morphology, particularly in the talus and calcaneus, have not been thoroughly explored.

To evaluate the morphological differences in the talus and calcaneus in individuals with cerebral palsy who have undergone LCL surgery compared to nonsurgical patients and controls.

Comparative cross-sectional study.

Thirty individuals were divided into three groups: control, surgical, and nonsurgical. Computed tomography scans were used to generate 3D models of the talus and calcaneus. Statistical shape modeling was employed to analyze and quantify shape variations, utilizing principal component analysis and Hotelling's T-squared test to identify significant morphological differences between groups.

LCL surgery resulted in significant morphological differences in the talus, including a more anterior tibiotalar joint and wider talonavicular articulating surface compared to nonsurgical patients and controls. Significant shape variations in the calcaneus were observed in the surgical group, with a smaller calcaneal tuberosity and altered subtalar facet. Hotelling's T-squared tests confirmed these significant differences between group mean shapes.

LCL surgery results in significant morphological alterations to the talus and calcaneus, suggesting the procedure affects not only the target bone but also neighboring structures. These changes may have long-term implications for foot biomechanics. Future research should investigate functional outcomes and explore longitudinal adaptations in bone shape following surgery.