Novel Reconstruction of a Static Medial Ligamentous Complex in a Flatfoot Model

作者:Tan Giselle J; Kadakia Anish R*; Thiele Ramon A Ruberte; Hughes Richard E
来源:Foot & Ankle International, 2010, 31(8): 695-700.
DOI:10.3113/FAI.2010.0695

摘要

Background: Little progress has been made addressing reconstruction of the static medial ligamentous structures of the foot. The purpose of this investigation was to reconstruct a flatfoot deformity with a novel static medial ligamentous complex (MLC) and evaluate its ability to correct talar head subluxation and radiographic deformity in a cadaveric model. Materials and Methods: Eight fresh frozen cadaveric specimens underwent cyclic preconditioning and static axial loading. Loading was applied to the intact foot, the severe flatfoot, and the reconstructed MLC foot. Anteroposterior (AP) and lateral radiographs were taken at each stage. The tab-first metatarsal angle, medial cuneiform height, talocalcaneal angle, and the calcaneal pitch angle were measured on the lateral views and the tab-first metatarsal angle was measured on the anteroposterior views. Results: Compared with the intact foot, the flatfoot showed significant change in the AP tab-first metatarsal angle (p = 0.001), the lateral tab-first metatarsal angle (p = 0.002), the medial cuneiform height (p = 0.007), the talocalcaneal angle (p = 0.03), and the calcaneal pitch angle (p = 0.018). After MLC reconstruction, there was a significant change in the AP tab-first metatarsal angle (p = 0.001), the lateral tab-first metatarsal angle (p = 0.002), and the medial cuneiform height (p = 0.007) and these values were not significantly different than the intact foot. The talocalcaneal angle and the calcaneal pitch angle remained significantly undercorrected after static MLC reconstruction. Conclusion: Static MLC reconstruction was effective in correcting several key radiographic parameters in a cadaveric flatfoot model. Clinical Relevance: The surgical technique evaluated here may be useful as a new soft tissue reconstructive procedure for treating adult flatfoot.

  • 出版日期2010-8