Felix Zeifang1, Steffen J Breusch, Leonhard Döderlein. 1. Orthopaedic University Hospital of Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg, Germany. Felix.Zeifang@ok.uni-heidelberg.de
Abstract
BACKGROUND: The purposes of this study were to evaluate the outcome of calcaneal lengthening in severe pediatric flexible flatfoot deformities of spastic origin and to determine the necessity of additional procedures. METHODS: In a prospective study, 32 patients (46 feet) were evaluated clinically and radiologically. The mean age of patients was 11 (range 4 to 22) years. The mean period of followup was 66 (range 36 to 108) months. RESULTS: Additional soft-tissue procedures (Strayer procedure, peroneus lengthening, reefing medial capsule) were performed in 39 of 46 feet; other bony procedures were performed in eight. Among the 46 feet, 11 outcomes were classified as excellent, 19 as good, nine as fair, and seven as poor. Poor outcome was related to overcorrection in three and deformity relapse in four. Calcaneocuboid subluxation was seen in nine feet. Radiographic evaluation demonstrated an improvement of all parameters determined. CONCLUSION: The Evans procedure is effective for the correction of severe, flexible flatfoot deformity in children with cerebral palsy in the short and mid term. Additional soft-tissue procedures frequently are required. However, correction of this multiplanar deformity predominantly occurs in the forefoot abduction component of the deformity, and the concomitant naviculocuneiform sag remains uncorrected. Despite successful outcomes, overcorrection and undercorrection remains a problem of clinical relevance.
BACKGROUND: The purposes of this study were to evaluate the outcome of calcaneal lengthening in severe pediatric flexible flatfoot deformities of spastic origin and to determine the necessity of additional procedures. METHODS: In a prospective study, 32 patients (46 feet) were evaluated clinically and radiologically. The mean age of patients was 11 (range 4 to 22) years. The mean period of followup was 66 (range 36 to 108) months. RESULTS: Additional soft-tissue procedures (Strayer procedure, peroneus lengthening, reefing medial capsule) were performed in 39 of 46 feet; other bony procedures were performed in eight. Among the 46 feet, 11 outcomes were classified as excellent, 19 as good, nine as fair, and seven as poor. Poor outcome was related to overcorrection in three and deformity relapse in four. Calcaneocuboid subluxation was seen in nine feet. Radiographic evaluation demonstrated an improvement of all parameters determined. CONCLUSION: The Evans procedure is effective for the correction of severe, flexible flatfoot deformity in children with cerebral palsy in the short and mid term. Additional soft-tissue procedures frequently are required. However, correction of this multiplanar deformity predominantly occurs in the forefoot abduction component of the deformity, and the concomitant naviculocuneiform sag remains uncorrected. Despite successful outcomes, overcorrection and undercorrection remains a problem of clinical relevance.
Authors: In Hyeok Lee; Chin Youb Chung; Kyoung Min Lee; Soon-Sun Kwon; Sang Young Moon; Ki Jin Jung; Myung Ki Chung; Moon Seok Park Journal: Clin Orthop Relat Res Date: 2014-11-14 Impact factor: 4.176
Authors: Dong Hun Suh; Jung Ho Park; Soon Hyuck Lee; Hak Jun Kim; Young Hwan Park; Woo Young Jang; Jung Heum Baek; Hyun Jae Sung; Gi Won Choi Journal: Int Orthop Date: 2019-01-30 Impact factor: 3.075