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Progressive collapsing foot deformity: short and mid-term correction with arthroereisis compared with lateral column
Héctor José Masaragian1, Fernando Perin1, Nicolas Ameriso1
1Foot and Ankle Surgeon, Buenos Aires, Argentina.
Background:
Progressive collapsing foot deformity (PCFD) grade I AB can cause progressive structural changes and functional limitations. Surgical intervention is indicated when deformity progression or symptoms significantly impair daily activities.
Purpose:
To compare the effectiveness of lateral column lengthening (LCL) and subtalar arthroereisis (STA) in the surgical treatment of early-stage PCFD.
Study Design:
Retrospective comparative study.
Methods:
Fifty-six patients with grade I AB PCFD were reviewed retrospectively; 16 underwent STA and 40 underwent LCL combined with medializing calcaneal osteotomy and medial soft tissue procedures. All radiographic measurements were performed by a single surgeon not involved in the surgeries. Primary outcomes were changes in angular parameters and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Mean follow-up was 28.6 months (range, 18-72 months).
Results:
Preoperative functional scores averaged 47.15 points, improving to 98.3 points postoperatively. Both techniques achieved statistically significant improvements in most angular parameters and functional scores. The Costa-Bartani angle did not significantly change in the STA group. No statistically significant differences were observed between groups in postoperative angular correction or functional scores. Patients aged 42-65 years showed greater improvements in the lateral talocalcaneal angle compared to other age groups, suggesting a possible age-related influence on certain radiographic outcomes.
Conclusion:
Both LCL and STA are effective surgical options for the management of early-stage PCFD, producing significant radiographic and functional improvements. Age may influence specific radiographic parameters, warranting further investigation.
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