Cargando…

Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot

BACKGROUND: The Malerba calcaneal Z-osteotomy is an operative procedure to treat the hindfoot varus component of adult cavovarus deformity. Basic science studies support the corrective ability of this osteotomy. However, there have been no published midterm clinical and radiographic results. The pur...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Jie, Ramanathan, Deepak, Adams, Samuel B., DeOrio, James K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827521/
https://www.ncbi.nlm.nih.gov/pubmed/36632335
http://dx.doi.org/10.1177/24730114221146986
_version_ 1784867072744882176
author Chen, Jie
Ramanathan, Deepak
Adams, Samuel B.
DeOrio, James K.
author_facet Chen, Jie
Ramanathan, Deepak
Adams, Samuel B.
DeOrio, James K.
author_sort Chen, Jie
collection PubMed
description BACKGROUND: The Malerba calcaneal Z-osteotomy is an operative procedure to treat the hindfoot varus component of adult cavovarus deformity. Basic science studies support the corrective ability of this osteotomy. However, there have been no published midterm clinical and radiographic results. The purpose of this article is to describe the radiographic and clinical improvement in a series of patients treated with this osteotomy. METHODS: A retrospective chart review identified 14 feet in 12 patients from January 2013 to August 2018 who met minimal follow-up criteria. Preoperative visual analog scale (VAS) scores, Foot Function Index (FFI) scores, and American Orthopaedic Foot & Ankle Society (AOFAS) scores were compared with postoperative scores. Preoperative Meary angle, calcaneal pitch, and hindfoot alignment were also compared with postoperative measurements. Complications and radiographic union were recorded. RESULTS: At a mean of 80 months, VAS, FFI, and AOFAS scores improved from 7.86 to 1.64, 57.78% to 18.11%, and 39.57 to 80.71, respectively (all P < .001). At a mean of 15 months, Meary angle, calcaneal pitch, and hindfoot alignment improved from 11.14 to 6.64 degrees (P < .001), 30.93 to 27.43 degrees (P = .005), and 19.83 degrees varus to 8.50 degrees varus (P < .001). There was 1 nonunion and 1 postoperative sural nerve neuralgia, but both patients ultimately did well clinically. There were no instances of postoperative tarsal tunnel syndrome. All patients stated that they would have the procedure done again. CONCLUSION: The calcaneal Z-osteotomy is an effective method to treat adult hindfoot cavovarus deformity. All patients had good clinical outcomes with minimal complications. LEVEL OF EVIDENCE: Level IV, case series.
format Online
Article
Text
id pubmed-9827521
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-98275212023-01-10 Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot Chen, Jie Ramanathan, Deepak Adams, Samuel B. DeOrio, James K. Foot Ankle Orthop Article BACKGROUND: The Malerba calcaneal Z-osteotomy is an operative procedure to treat the hindfoot varus component of adult cavovarus deformity. Basic science studies support the corrective ability of this osteotomy. However, there have been no published midterm clinical and radiographic results. The purpose of this article is to describe the radiographic and clinical improvement in a series of patients treated with this osteotomy. METHODS: A retrospective chart review identified 14 feet in 12 patients from January 2013 to August 2018 who met minimal follow-up criteria. Preoperative visual analog scale (VAS) scores, Foot Function Index (FFI) scores, and American Orthopaedic Foot & Ankle Society (AOFAS) scores were compared with postoperative scores. Preoperative Meary angle, calcaneal pitch, and hindfoot alignment were also compared with postoperative measurements. Complications and radiographic union were recorded. RESULTS: At a mean of 80 months, VAS, FFI, and AOFAS scores improved from 7.86 to 1.64, 57.78% to 18.11%, and 39.57 to 80.71, respectively (all P < .001). At a mean of 15 months, Meary angle, calcaneal pitch, and hindfoot alignment improved from 11.14 to 6.64 degrees (P < .001), 30.93 to 27.43 degrees (P = .005), and 19.83 degrees varus to 8.50 degrees varus (P < .001). There was 1 nonunion and 1 postoperative sural nerve neuralgia, but both patients ultimately did well clinically. There were no instances of postoperative tarsal tunnel syndrome. All patients stated that they would have the procedure done again. CONCLUSION: The calcaneal Z-osteotomy is an effective method to treat adult hindfoot cavovarus deformity. All patients had good clinical outcomes with minimal complications. LEVEL OF EVIDENCE: Level IV, case series. SAGE Publications 2023-01-03 /pmc/articles/PMC9827521/ /pubmed/36632335 http://dx.doi.org/10.1177/24730114221146986 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Chen, Jie
Ramanathan, Deepak
Adams, Samuel B.
DeOrio, James K.
Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title_full Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title_fullStr Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title_full_unstemmed Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title_short Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot
title_sort midterm clinical and radiographic outcomes of the calcaneal z-osteotomy for the correction of cavovarus foot
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827521/
https://www.ncbi.nlm.nih.gov/pubmed/36632335
http://dx.doi.org/10.1177/24730114221146986
work_keys_str_mv AT chenjie midtermclinicalandradiographicoutcomesofthecalcanealzosteotomyforthecorrectionofcavovarusfoot
AT ramanathandeepak midtermclinicalandradiographicoutcomesofthecalcanealzosteotomyforthecorrectionofcavovarusfoot
AT adamssamuelb midtermclinicalandradiographicoutcomesofthecalcanealzosteotomyforthecorrectionofcavovarusfoot
AT deoriojamesk midtermclinicalandradiographicoutcomesofthecalcanealzosteotomyforthecorrectionofcavovarusfoot