Lag Screw with Plantar Plating for Naviculocuneiform Arthrodesis in Progressive Collapsing Foot Deformity
| Autor: | Derek M. Klavas MD, Austin E. Wininger, Stephanie S. Gardner MD, Jason S. Ahuero MD, Kevin E. Varner MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 7 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011421S00284 |
| Popis: | Category: Midfoot/Forefoot Introduction/Purpose: Medial column procedures are a common adjunct to progressive collapsing foot deformity (PCFD) correction. In particular, naviculocuneiform (NC) arthrodesis could be performed when degeneration or instability at the NC joint is contributing to arch collapse. Plantar plate fusion resists gapping along the tension side of the joint, potentially reducing risk of non-union and recurrent deformity. Additionally, by placing the hardware in a plantar location there is an increased soft tissue envelope to function in a protective matter and eliminate the possibility of hardware prominence and tendon irritation. The purpose of this study was to analyze short-term clinical and radiographic outcomes of NC fusion using a lag screw with plantar plating technique. Methods: A single-surgeon retrospective case series was performed on patients with PCFD and medial arch collapse treated with NC arthrodesis using a lag screw plus plantar plating technique between January 2016 and December 2019, with a minimum six month clinical and radiographic follow up. Patients undergoing revision NC joint arthrodesis, patients with incomplete imaging, or an arthrodesis technique that did not utilize NC joint plantar plating were excluded. Demographic data, perioperative data, complications, and reoperations were recorded from electronic medical records. Pre-operative AOFAS midfoot scores were calculated at the initial clinic visit and then again at the patients' most recent follow-up. In the case of most recent follow up occurring prior to six months post-operatively, a telemedicine visit was performed. Anteroposterior (AP) and lateral talo-first metatarsal angles, talonavicular coverage angle, and calcaneal pitch were measured independently by three authors. Fusion was confirmed radiographically and computed topography when union was in question. Results: Nineteen patients (15 female, 4 male; 11 right, 8 left) with a mean age of 56.6 years and a mean follow-up of 21.0 +- 13.4 months were reviewed. A mean 3.4 concomitant procedures were performed at the time of NC fusion. AP talo-first metatarsal angle (18.9° to 5.2°), lateral talo-first metatarsal angel (-18.7° to -4.4°), talonavicular coverage angle (28.1° to 7.4°), and calcaneal pitch (14.6° to 20.1°) all improved significantly (p |
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