Union in Lateral Column Lengthening by Plate Fixation Without Bone Graft in Flexible Flatfoot: A Case Series

Mohamed Hegazy El-Sharkasy; Abdel Aziz El-Singergy; Ali M Reda Mansour; Mostafa Ahmed Badawy; Ahmed Khedr

doi:10.1007/s43465-023-00945-z

Union in Lateral Column Lengthening by Plate Fixation Without Bone Graft in Flexible Flatfoot: A Case Series

Indian J Orthop. 2023 Jul 12;57(8):1283-1289. doi: 10.1007/s43465-023-00945-z. eCollection 2023 Aug.

Authors

Mohamed Hegazy El-Sharkasy^{1

2}, Abdel Aziz El-Singergy², Ali M Reda Mansour², Mostafa Ahmed Badawy³, Ahmed Khedr²

Affiliations

¹ Orthopedic Surgery Department, Shoubra General Hospital, Cairo, Egypt.
² Orthopedic Surgery Department, Kasr Alainy Hospital, Cairo University, Cairo, Egypt.
³ Orthopedic Department, El Sahel Teaching Hospital, Cairo, Egypt.

PMID: 37525734
PMCID: PMC10387035 (available on 2024-07-12)
DOI: 10.1007/s43465-023-00945-z

Abstract

Purpose: This study's goal was to evaluate the outcomes of lateral column lengthening by plate fixation without bone graft in the management of symptomatic flexible flatfoot.

Methods: A prospective randomized trial study included 30 feet (27 patients) and was performed from March 2017 to December 2019. Functional and radiological evaluations were done pre-operative and at the final post-operative follow-up. The functional assessment was done using the American Orthopaedic Foot and Ankle Society (AOFAS) score.

Results: The mean follow-up was 16.5 ± 3.027 months. The mean age of patients was 22.6 ± 6.29 years. All cases showed union ranging from 8 to 12 weeks, with a mean of 10 ± 1.88 weeks. The mean AOFAS score improved from 51.6 ± 6.75 to 92.2 ± 6.21. The mean anteroposterior (AP) talo-first metatarsal angle improved from 25.3° ± 8.31° to 3.4° ± 5.10°. The mean anteroposterior (AP) talo-navicular coverage improved from 22.10° ± 4.28° to 2.3° ± 3.46°. The mean Lateral talo-first metatarsal angle improved from 18.6° ± 4.79° to 3.3° ± 3.16°. The calcaneal pitch angle improved from 9.6° ± 4.14° to 15.1° ± 4.43°. The mean lateral talo-calcaneal angle improved from 45.7° ± 3.77° to 37.5° ± 3.47°.

Conclusion: Using an interposition wedge plate for LCL without bone graft leads to a high union rate, maintains the correction, and avoids possible complications of autografts and allografts.

Keywords: Bone graft; Evans osteotomy; Flexible flatfoot; Lateral column lengthening; Plate.

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