Three-dimensional displacement after a medializing calcaneal osteotomy in relation to the osteotomy angle and hindfoot alignment |
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| Institution: | 1. Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium;2. Movement Analysis Laboratory and Functional-Clinical Evaluation of Prosthesis, IRCCS Istituto Ortopedico Rizzoli, via di Barbiano, 1/10, 40136 Bologna, Italy;3. Department of Orthopaedic Surgery, AZ Groeninge, President Kennedylaan 4, 8500 Kortrijk, Belgium;4. Department of Orthopaedic Surgery, AZ Monica, Florent Pauwelslei 21, 2100 Deurne, Belgium;5. University Orthopaedic Center, University of Utah, 590 Wakara Way Salt Lake City, UT 84108, USA;1. Bone and Joint Diseases Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;2. Trauma Research Center, Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;3. Bone and Joint Diseases Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;1. Department of Trauma Surgery, Otto-von-Guericke University, Leipziger Str. 44 Magdeburg, Germany;2. Gesellschaft für klinische und Versorgungsforschung mbH, Halberstädter Str. 40a, Magdeburg, Germany;1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Seongnam, Gyeonggi 13620, South Korea;2. Department of Mathematics, College of Natural Sciences, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi 16499, South Korea;1. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy;2. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy;3. Università degli Studi di Milano, Italy |
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| Abstract: | BackgroundA medializing calcaneal osteotomy is frequently performed to correct adult-acquired flatfoot deformities, but there is lack of data on the associated three-dimensional variables defining the final correction. The aim of this study was to assess the correlation between the pre-operative hindfoot valgus deformity and calcaneal osteotomy angles and the post-operative calcaneal displacement.MethodsWeight-bearing CT scans obtained pre- and post-operatively were retrospectively analyzed for sixteen patients. Corresponding three-dimensional bone models were used to measure valgus deformity pre- and post-operatively, inclination of the osteotomy and displacement of the calcaneus. Linear regression was conducted to assess the relationship between these measurements.ResultsOn average, the hindfoot valgus changed from 13.1° (±4.6) pre-operatively to 5.7° (±4.3) post-operatively. A mean inferior displacement of 3.2 mm (±1.3) was observed along the osteotomy with a mean inclination of 54.6° (±5.6), 80.5° (±10.7), ?13.7° (±15.7) in the axial, sagittal and coronal planes, respectively. A statistically significant positive relationship (p < .05, R2 = 0.6) was found between the pre-operative valgus, the axial osteotomy inclination, and the inferior displacement.ConclusionsThis study shows that the degree of pre-operative hindfoot valgus and the axial osteotomy angle are predictive factors for the amount of post-operative inferior displacement of the calcaneus. These findings demonstrate the added value of a computer-based pre-operative planning in clinical practice.Level of evidence II Prospective comparative study. |
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| Keywords: | Adult-acquired flatfoot deformity Computer-aided design Hindfoot alignment Medializing calcaneal osteotomy Weight-bearing CT |
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