Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents

Abstract Background Evans calcaneal lengthening osteotomy is used to treat symptomatic flexible flatfoot when conservative treatment fails. Grafts such as autologous iliac bone grafts, allografts, and xenografts are implanted at the osteotomy site to lengthen the lateral column of the hindfoot. This...

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Autores principales:	Chien-Cheng Lai, Ting-Ming Wang, Chih-Hung Chang, Jwo-Luen Pao, Hsu-Wei Fang, Chun-Chien Chang, Shang-Ming Lin, Tsung-yu Lan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Flexible flatfoot Evans calcaneal lengthening Ipsilateral mid-fibula bone autograft Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/e0a4099c671d4622be18eb9f69395e91
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spelling	oai:doaj.org-article:e0a4099c671d4622be18eb9f69395e912021-11-28T12:24:30ZCalcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents10.1186/s12891-021-04855-91471-2474https://doaj.org/article/e0a4099c671d4622be18eb9f69395e912021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04855-9https://doaj.org/toc/1471-2474Abstract Background Evans calcaneal lengthening osteotomy is used to treat symptomatic flexible flatfoot when conservative treatment fails. Grafts such as autologous iliac bone grafts, allografts, and xenografts are implanted at the osteotomy site to lengthen the lateral column of the hindfoot. This study aimed to present the outcomes of an autologous mid-fibula bone graft used for calcaneal lengthening in symptomatic pes valgus in adolescents. Methods We retrospectively examined 23 ft of 13 adolescents who underwent surgery between July 2014 and January 2018. The radiological and clinical outcomes (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale scores) were assessed during a mean follow-up of 49.7 (range, 30.9–73.4) months. The mean distance of the lengthening site was measured to evaluate graft sinking or collapse. The Goldberg scoring system was used to determine the degree of union at the donor and recipient sites. Results The calcaneal pitch and the anteroposterior and lateral talo-first metatarsal (Meary) angles showed significant correction, from 14.4 to 19.6 (p < 0.001), and from 14.5 to 4.6 (p < 0.001) and 13.5 to 8.5 (p < 0.001), respectively. The mean distance of the lengthening site showed no significant change (p = 0.203), suggesting no graft sinking or postoperative collapse. The lateral distal tibial angle showed no significant difference (p = 0.398), suggesting no postoperative ankle valgus changes. Healing of the recipient and donor sites occurred in 23 and 21 ft, respectively. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scores improved significantly, from 68.0 to 98.5 (p < 0.001). Conclusions Evans calcaneal lengthening using an ipsilateral mid-fibula bone autograft resulted in significant improvement in clinical and radiological outcomes without ankle valgus deformity. Hence, it could be a treatment option for lateral column calcaneal lengthening in adolescents.Chien-Cheng LaiTing-Ming WangChih-Hung ChangJwo-Luen PaoHsu-Wei FangChun-Chien ChangShang-Ming LinTsung-yu LanBMCarticleFlexible flatfootEvans calcaneal lengtheningIpsilateral mid-fibula bone autograftDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Flexible flatfoot Evans calcaneal lengthening Ipsilateral mid-fibula bone autograft Diseases of the musculoskeletal system RC925-935
spellingShingle	Flexible flatfoot Evans calcaneal lengthening Ipsilateral mid-fibula bone autograft Diseases of the musculoskeletal system RC925-935 Chien-Cheng Lai Ting-Ming Wang Chih-Hung Chang Jwo-Luen Pao Hsu-Wei Fang Chun-Chien Chang Shang-Ming Lin Tsung-yu Lan Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
description	Abstract Background Evans calcaneal lengthening osteotomy is used to treat symptomatic flexible flatfoot when conservative treatment fails. Grafts such as autologous iliac bone grafts, allografts, and xenografts are implanted at the osteotomy site to lengthen the lateral column of the hindfoot. This study aimed to present the outcomes of an autologous mid-fibula bone graft used for calcaneal lengthening in symptomatic pes valgus in adolescents. Methods We retrospectively examined 23 ft of 13 adolescents who underwent surgery between July 2014 and January 2018. The radiological and clinical outcomes (American Orthopaedic Foot and Ankle Society ankle-hindfoot scale scores) were assessed during a mean follow-up of 49.7 (range, 30.9–73.4) months. The mean distance of the lengthening site was measured to evaluate graft sinking or collapse. The Goldberg scoring system was used to determine the degree of union at the donor and recipient sites. Results The calcaneal pitch and the anteroposterior and lateral talo-first metatarsal (Meary) angles showed significant correction, from 14.4 to 19.6 (p < 0.001), and from 14.5 to 4.6 (p < 0.001) and 13.5 to 8.5 (p < 0.001), respectively. The mean distance of the lengthening site showed no significant change (p = 0.203), suggesting no graft sinking or postoperative collapse. The lateral distal tibial angle showed no significant difference (p = 0.398), suggesting no postoperative ankle valgus changes. Healing of the recipient and donor sites occurred in 23 and 21 ft, respectively. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scores improved significantly, from 68.0 to 98.5 (p < 0.001). Conclusions Evans calcaneal lengthening using an ipsilateral mid-fibula bone autograft resulted in significant improvement in clinical and radiological outcomes without ankle valgus deformity. Hence, it could be a treatment option for lateral column calcaneal lengthening in adolescents.
format	article
author	Chien-Cheng Lai Ting-Ming Wang Chih-Hung Chang Jwo-Luen Pao Hsu-Wei Fang Chun-Chien Chang Shang-Ming Lin Tsung-yu Lan
author_facet	Chien-Cheng Lai Ting-Ming Wang Chih-Hung Chang Jwo-Luen Pao Hsu-Wei Fang Chun-Chien Chang Shang-Ming Lin Tsung-yu Lan
author_sort	Chien-Cheng Lai
title	Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
title_short	Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
title_full	Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
title_fullStr	Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
title_full_unstemmed	Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
title_sort	calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e0a4099c671d4622be18eb9f69395e91
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Calcaneal lengthening using ipsilateral fibula autograft in the treatment of symptomatic pes valgus in adolescents

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