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Calcaneocuboid joint pressures with lateral column lengthening (Evans) procedure
P S Cooper1, M D Nowak, J Shaer
1Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington 06032, USA.
Foot & Ankle International
|April 1, 1997
Summary
The Evans procedure for adult flatfoot may cause high calcaneocuboid joint pressures, potentially leading to arthrosis. Calcaneocuboid distraction arthrodesis may be a safer alternative for joint lengthening.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Podiatric medicine
Background:
- Adult acquired flatfoot is a common condition.
- The Evans lateral column lengthening procedure is used in pediatric cases.
- Potential complications in adults are not fully understood.
Purpose of the Study:
- To evaluate calcaneocuboid joint pressures during lateral column lengthening.
- To compare the Evans procedure with calcaneocuboid distraction arthrodesis in adults.
Main Methods:
- Eight cadaver specimens were used.
- Real-time pressures were measured using a TekScan 4200 sensor pad.
- Measurements were taken at 0, 5, and 10 mm lengthening under unloaded and 350-newton loaded conditions.
Main Results:
- Pressures exceeded 2.3 MPa in the loaded model at 10 mm lateral column lengthening.
- The Evans procedure demonstrated high pressures in the calcaneocuboid joint.
- Calcaneocuboid distraction arthrodesis was not explicitly tested but proposed as an alternative.
Conclusions:
- The Evans lateral column lengthening may lead to excessive calcaneocuboid joint pressures in adults.
- This excessive pressure could result in joint arthrosis.
- Calcaneocuboid distraction arthrodesis is suggested as a potentially less problematic surgical option.
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