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Lengthening osteotomy, flexor digitorum longus transfer reliable for flatfoot deformity correction
All patients showed improvement in all parameters at 2 years and their talo-first metatarsal index and pedography normalized, researchers noted.
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Researchers found that lengthening osteotomies of the calcaneus and flexor digitorum longus tendon transfers adequately corrected adult acquired flatfoot deformity, according to a study that also found these procedures improved the talo-first metatarsal index.
“Soft tissue treatment alone cannot correct bony deformity,” investigator Martinus Richter, MD, PhD, said at a meeting where he presented results with these techniques.
In their investigation, Richter and colleagues examined the amount of correction for and clinical outcomes of flexor digitorum longus tendon transfer and lengthening osteotomy of the calcaneus as a treatment for adult acquired flatfoot deformity. They conducted a prospective, clinical follow-up study of 112 feet in 102 patients (42% male; mean age 58.2 years).
Patients underwent flexor digitorum longus tendon transfer and lengthening osteotomy of the calcaneus for adult acquired flatfoot deformity between September 1, 2006 and August 31, 2009.
Depicted in this radiograph is an adult patient’s flatfoot deformity prior to correction with a flexor digitorum longus tendon transfer and lengthening osteotomy of the calcaneus.
Following the corrective procedure, this patient’s foot had a normalized pedography and talo-first metatarsal index. All patients studied achieved full weightbearing at 7 postoperative weeks.
Images: Richter M
According to information in the presentation that Richter made, the researchers conducted patient examinations preoperatively and at the 2-year follow-up. Outcome measures included stages of posterior tibialis insufficiency, talo-first metatarsal (TMT) index, pedographic midfoot contact area, force percentage and Visual Analog Scale (VAS) of the foot and ankle.
The investigators found all patients improved in all parameters at the 2-year follow-up. The TMT index normalized, as did the pedography, and posterior tibialis insufficiency and pedography improved, as well, Richter said when he presented the results. At 7 weeks postoperatively, the patients achieved 100% weightbearing.
Richter and colleagues noted few complications with the procedure.
“This method allows safe and reliable correction of adult acquired flatfoot deformity,” Richter said. – by Renee Blisard Buddle
- Reference:
- Richter M. Lengthening osteotomy of the calcaneus and flexor digitorum longus tendon transfer in adult acquired flatfoot deformity improves talo-1st metatarsal-index. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; June 21-23, 2012; San Diego.
- For more information:
- Martinus Richter, MD, PhD, can be reached at Department of Foot and Ankle Surgery Nuremberg and Rummelsberg, Hospital Rummelsberg, 90592 Schwarzenbruck, Germany; email: martinus.richter@sana.de.
Disclosure: Richter receives royalties from and is a paid consultant to Small Bone Innovations.