Evans Osteotomy Without Bone Graft in Stage IIB Adult Flatfoot Deformity

Authors

DOI:

https://doi.org/10.15417/issn.1852-7434.2023.88.1.1631

Keywords:

Flatfoot deformity, Evans osteotomy, lateral column lengthening

Abstract

Objective: To evaluate the radiological and functional outcomes one year after surgery in a consecutive series of patients diagnosed with stage IIB adult-acquired flatfoot deformity who underwent Evans osteotomy without the use of bone graft.

Materials and Methods: Two groups of patients were retrospectively evaluated: group 1 (spacer plate, n=12) and group 2 (PEEK cage, n=14). The mean age was 47 years (SD 18) in group 1 and 54 years (SD 12) in group 2.

Results: 26 patients (28 feet) were evaluated; 14 (84%) of the patients were women. Radiographic measurements—calcaneal pitch angle, (lateral) talocalcaneal angle, (AP) talocalcaneal angle, talonavicular coverage angle, medial column height, lateral column length—yielded statistically significant differences
between preoperative measurements and those taken one year after surgery. The mean score on the AOFAS scale one year after surgery was 96 (SD 4.70) in group 1 and 95 (SD 4.98) in group 2. Regarding the visual analog scale, it was 1.2 (SD 0.42) in group 1 and 1.16 (SD 0.46) in group 2.

Conclusions: According to the results obtained, we conclude that Evans osteotomy without the use of bone graft manages to preserve the corrections obtained in the medium term, using either spacer plates or PEEK cages.

Downloads

Download data is not yet available.

Author Biographies

  • Daniel Sebastián Villena, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Pablo Sotelano, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • María Gala Santini Araujo, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Leonardo Conti, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Ana Cecilia Parise, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

  • Marina Carrasco, Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

    Foot and Ankle Medicine and Surgery Sector, Orthopedics and Traumatology Service “Prof. Dr. Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

References

Mann RA, Saltzman CL. Coughlin Pie y Tobillo. Madrid: Editorial Marban; 2011.

Sands AK, Tansey JP. Lateral column lengthening. Foot Ankle Clin 2007;12(2):301-8. https://doi.org/10.1016/j.fcl.2007.03.007 DOI: https://doi.org/10.1016/j.fcl.2007.03.007

Bare AA, Haddad SL. Tenosynovitis of the posterior tibial tendon. Foot Ankle Clin 2001;6:37-66.

https://doi.org/10.1016/s1083-7515(03)00078-0 DOI: https://doi.org/10.1016/S1083-7515(03)00078-0

Beals TC, Pomeroy GC, Manoli A 2nd. Posterior tendon insufficiency: diagnosis and treatment. J Am Acad Orthop Surg 1999;7(2):112-8. https://doi.org/10.5435/00124635-199903000-00004 DOI: https://doi.org/10.5435/00124635-199903000-00004

Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop Relat Res 1989;(239):196-206. DOI: https://doi.org/10.1097/00003086-198902000-00022

PMID: 2912622

Bluman EM, Title CI, Myerson MS. Posterior tibial tendon rupture: A refined classification system. Foot Ankle Clin 2007;12(2):233-49. https://doi.org/10.1016/j.fcl.2007.03.003 DOI: https://doi.org/10.1016/j.fcl.2007.03.003

Coughlin M, Kaz A. Correlation of Harris mats, physical exam, pictures, and radiographic measurements in adult flatfoot deformity. Foot Ankle Int 2009;30(7):604-12. https://doi.org/10.3113/FAI.2009.0604 DOI: https://doi.org/10.3113/FAI.2009.0604

Niño Gomez D, Eslava S, Anain F, Yearson D, Arrondo G, Joannas G. Use of poly (ether ether ketone) cages in foot and ankle surgery. Foot Ankle Clin 2012;17(3):449-57. https://doi.org/10.1016/j.fcl.2012.07.001 DOI: https://doi.org/10.1016/j.fcl.2012.07.001

Hiller L, Pinney SJ. Surgical treatment of acquired flatfoot deformity: what is the state of practice among academic foot and ankle surgeons in 2002? Foot Ankle Int 2003;24(9):701-5. https://doi.org/10.1177/107110070302400909 DOI: https://doi.org/10.1177/107110070302400909

Hintermann B, Valderrabano V, Kundert HP. Lengthening of the lateral column and reconstruction of the medial soft tissue for treatment of acquired flatfoot deformity associated with insufficiency of the posterior tibial tendon. Foot Ankle Int 1999;20(10):622-9. https://doi.org/10.1177/107110079902001002 DOI: https://doi.org/10.1177/107110079902001002

Liao JC, Niu CC, Chen WJ, Chen LH. Polyetheretherketone (PEEK) cage filled with cancellous allograft in anterior cervical discectomy and fusion. Int Orthop 2008;32(5):643-8. https://doi.org/10.1007/s00264-007-0378-x DOI: https://doi.org/10.1007/s00264-007-0378-x

Ahn JY, Lee HS, Kim CH, Yang JP, Park SS. Calcaneocuboid joint subluxation after the calcaneal lengthening

procedure in children. Foot Ankle Int 2014;35(7):677-82. https://doi.org/10.1177/1071100714528494 DOI: https://doi.org/10.1177/1071100714528494

Chan JY, Greenfield ST, Soukup DS, Do HT, Deland JT, Ellis SJ. Contribution of lateral column lengthening

to correction of forefoot abduction in stage IIb adult acquired flatfoot deformity reconstruction. Foot Ankle Int

;36(12):1400-11. https://doi.org/10.1177/1071100715596607 DOI: https://doi.org/10.1177/1071100715596607

Benthien RA, Parks BG, Guyton GP, Schon LC. Lateral column calcaneal lengthening, flexor digitorum longus

transfer, and opening wedge medial cuneiform osteotomy for flexible flatfoot: a biomechanical study. Foot Ankle Int 2007;28(1):70-7. https://doi.org/10.3113/FAI.2007.0013 DOI: https://doi.org/10.3113/FAI.2007.0013

Kang S, Charlton TP, Thordarson DB. Lateral column lengthening in adult flatfoot deformity. Foot Ankle Int

;34(3):392-7. https://doi.org/10.1177/1071100712465738 DOI: https://doi.org/10.1177/1071100712465738

Younger EM, Chapman MW. Morbidity at bone graft donor sites. J Orthop Trauma 1989;3(3):192-5.

https://doi.org/10.1097/00005131-198909000-00002 DOI: https://doi.org/10.1097/00005131-198909000-00002

Cockin J. Autologous bone grafting complications at the donor site. J Bone Joint Surg Br 1971;53(1):153.

https://doi.org/10.1302/0301-620X.53B1.147 DOI: https://doi.org/10.1302/0301-620X.53B1.147

Shin AY, Moran ME, Wenger DR. Superior gluteal artery injury secondary to posterior iliac crest bone graft

harvesting. Spine (Phila Pa 1976) 1996;21(11):1371-4. https://doi.org/10.1097/00007632-199606010-00019 DOI: https://doi.org/10.1097/00007632-199606010-00019

Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA. Complications of iliac crest bone graft

harvesting. Clin Orthop Relat Res 1996;(329):300-9. https://doi.org/10.1097/00003086-199608000-00037 DOI: https://doi.org/10.1097/00003086-199608000-00037

Tomford WW, Starkweather RJ, Goldman MH. A study of the clinical incidence of infection in the use of banked allograft bone. J Bone Joint Surg Am 1981;63(2):244-8. PMID: 7007391 DOI: https://doi.org/10.2106/00004623-198163020-00010

Cooper PS, Nowak MD, Shaer J. Calcaneocuboid joint pressures with lateral column lengthening (Evans)

procedure. Foot Ankle Int 1997;18(4):199-205. https://doi.org/10.1177/107110079701800403 DOI: https://doi.org/10.1177/107110079701800403

Xia J, Zhang P, Yang YF, Zhou JQ, Li QM, Yu GR. Biomechanical analysis of the calcaneocuboid joint pressure

after sequential lengthening of the lateral column. Foot Ankle Int 2013;34(2):261-6. https://doi.org/10.1177/1071100712464211 DOI: https://doi.org/10.1177/1071100712464211

Momberger N, Morgan JM, Bachus KN, West JR. Calcaneocuboid joint pressure after lateral column lengthening in a cadaveric planovalgus deformity model. Foot Ankle Int 2000;21(9):730-5. https://doi.org/10.1177/107110070002100903 DOI: https://doi.org/10.1177/107110070002100903

Published

2023-02-17

Issue

Section

Clinical Research

Categories

How to Cite

Evans Osteotomy Without Bone Graft in Stage IIB Adult Flatfoot Deformity. (2023). Revista de la Asociación Argentina de Ortopedia Y Traumatología, 88(1), 13-21. https://doi.org/10.15417/issn.1852-7434.2023.88.1.1631

Most read articles by the same author(s)

1 2 > >>