Gabriel Ferraz Ferreira1, Natássia Nava2, Thomas Stravinskas Durigon2, Tatiana Ferreira Dos Santos3, Miguel Viana Pereira Filho4. 1. Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, Rua Cerro Corá, 585, São Paulo, SP, CEP 05061-150, Brazil. gabriel.ferraz38@yahoo.com.br. 2. Department of Orthopaedics and Traumatology, Prevent Senior, São Paulo, Brazil. 3. Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, Rua Cerro Corá, 585, São Paulo, SP, CEP 05061-150, Brazil. 4. Head of Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil. miguel.viana.filho@gmail.com.
Abstract
BACKGROUND: Hindfoot arthrodesis is used in patients with advanced-stage acquired flatfoot, usually associated with degenerative joint disease. The objective of the present study was to evaluate the clinical and radiographic results of hindfoot arthrodesis using the single-incision medial approach. METHODS: A case series of 18 consecutive patients undergoing surgical correction between 2015 and 2018 with hindfoot arthrodesis using the medial approach was evaluated. The clinical assessment used the visual analog pain scale, AOFAS hindfoot score, SF-36, and foot function index. Radiographs and personal satisfaction criteria were also analyzed. RESULTS: All radiographic parameters evaluated showed a significant improvement (p < .05), except the calcaneal pitch. Pain decreased by 5.1 points (p < .001), and the mean final AOFAS score was 72.6. In three feet, a new surgery was required. Two feet developed talar necrosis. None of the cases presented surgical wound dehiscence, and two presented with superficial infection, which was resolved with the use of oral antibiotics. CONCLUSION: Double arthrodesis (subtalar and talonavicular) to correct adult-acquired valgus flatfoot using a medial approach has a low risk of soft tissue complications and presents satisfactory functional results. Avascular necrosis is a serious complication that was present in 11% of cases.
BACKGROUND: Hindfoot arthrodesis is used in patients with advanced-stage acquired flatfoot, usually associated with degenerative joint disease. The objective of the present study was to evaluate the clinical and radiographic results of hindfoot arthrodesis using the single-incision medial approach. METHODS: A case series of 18 consecutive patients undergoing surgical correction between 2015 and 2018 with hindfoot arthrodesis using the medial approach was evaluated. The clinical assessment used the visual analog pain scale, AOFAS hindfoot score, SF-36, and foot function index. Radiographs and personal satisfaction criteria were also analyzed. RESULTS: All radiographic parameters evaluated showed a significant improvement (p < .05), except the calcaneal pitch. Pain decreased by 5.1 points (p < .001), and the mean final AOFAS score was 72.6. In three feet, a new surgery was required. Two feet developed talar necrosis. None of the cases presented surgical wound dehiscence, and two presented with superficial infection, which was resolved with the use of oral antibiotics. CONCLUSION: Double arthrodesis (subtalar and talonavicular) to correct adult-acquired valgus flatfoot using a medial approach has a low risk of soft tissue complications and presents satisfactory functional results. Avascular necrosis is a serious complication that was present in 11% of cases.
Authors: Sebastian Fischer; Julia Oepping; Jan Altmeppen; Yves Gramlich; Oliver Neun; Sebastian Manegold; Reinhard Hoffmann Journal: J Clin Med Date: 2022-02-05 Impact factor: 4.241