Revista espanola de cirugia ortopedica y traumatologia · 2025
Isolated medial displacement calcaneal osteotomy for treating talo-calcaneal coalition in flat feet-adult population: Is alignment the main problem?
СтатьяНазвание и аннотация: Перевод в очереди
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Slullitel G, Fa-Binefa M, Martínez de Albornoz P, Oller Boix A, Dopazo González N, Fernández Cebrián A, Monteagudo M
Аннотация
INTRODUCTION: Talo-calcaneal coalition (TCC), presents a significant challenge in adult patients, often associated with pes planus and pes cavus. The aim of this study was to assess the effect of Medial Displacement Calcaneal Osteotomy (MDCO) on TTC.
MATERIALS AND METHODS: This study retrospectively analyzed 11 adult patients diagnosed with rigid flat feet caused by TCC, who underwent MDCO without coalition resection. Clinical and radiographic outcomes were assessed using questionnaires (ADL-FAAM, VAS and Likert scale) and imaging (Talar-first Metatarsal angle, Talo-calcaneal angle, both in AP and lateral views, and Talo-navicular Coverage) preoperatively and at one-year follow-up. Postoperative complications, infections or subsequent surgical procedures were also registered during follow up.
RESULTS: One year postoperatively, the mean improvement in ADL-FAAM was -49 (SD 15.73), VAS was -6.7 (SD 1.21) and Likert scale -2.6 (SD 0.46). Radiographic analysis post-surgery revealed minimal changes, emphasizing that the substantial clinical benefits were primarily due to the correction of malalignment. A significant correlation was found between talo-calcaneal angles and talo-navicular coverage with postoperative FAAM scores (p=0.011, p=0.047), and talo-calcaneal angles with Likert scores (p=0.05, p=0.008). Patients with more severe preoperative valgus deformities experienced increased improvement.
CONCLUSION: MDCO without coalition resection offers a treatment alternative for adults with TCC-induced flatfoot.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
MATERIALS AND METHODS: This study retrospectively analyzed 11 adult patients diagnosed with rigid flat feet caused by TCC, who underwent MDCO without coalition resection. Clinical and radiographic outcomes were assessed using questionnaires (ADL-FAAM, VAS and Likert scale) and imaging (Talar-first Metatarsal angle, Talo-calcaneal angle, both in AP and lateral views, and Talo-navicular Coverage) preoperatively and at one-year follow-up. Postoperative complications, infections or subsequent surgical procedures were also registered during follow up.
RESULTS: One year postoperatively, the mean improvement in ADL-FAAM was -49 (SD 15.73), VAS was -6.7 (SD 1.21) and Likert scale -2.6 (SD 0.46). Radiographic analysis post-surgery revealed minimal changes, emphasizing that the substantial clinical benefits were primarily due to the correction of malalignment. A significant correlation was found between talo-calcaneal angles and talo-navicular coverage with postoperative FAAM scores (p=0.011, p=0.047), and talo-calcaneal angles with Likert scores (p=0.05, p=0.008). Patients with more severe preoperative valgus deformities experienced increased improvement.
CONCLUSION: MDCO without coalition resection offers a treatment alternative for adults with TCC-induced flatfoot.
LEVEL OF EVIDENCE: Level IV, retrospective case series.