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Lateral Column Lengthening with Expandable Cubic Cage

March 15, 2015

Contributors: Ilker Abdullah Sarikaya, MD; Enis Yildirim, MD; Muharrem Inan, MD; Muharrem Inan, MD

Keywords: Bony Procedure

Planovalgus foot is a major source of disability in children with cerebral palsy (CP), with the incidence up to 25%. Planovalgus foot is clinically associated with depression of the medial arch, walking disabilities, callosities and ulcerations, and pain. Treatment options in the literature include: use of orthotics, peroneal muscle lengthening, calcaneal lengthening, subtalar fusion, and triple arthrodesis. Evans has proposed a calcaneal lengthening procedure to correct planovalgus deformity in the ambulatory child with spastic CP. Although high success rates were reported in literature, some complications were informed such as early graft dislocation, reduction loss, donor site morbidity, nonunion, or delayed union. Evans' intracalcaneal technique was used as described by Mosca. Then, an expandable titanium cubic cage was inserted into the osteotomy gap based on the amount of talonavicular coverage needed. The length of the gastrocnemius and soleus muscles were also checked. If the ankle dorsiflexion did not rest in the neutral position with the knee flexed, an Achilles tendon lengthening was performed. A short leg plaster cast was applied after the procedure. We treated planovalgus foot deformity in CP with calcaneal lengthening by using new titanium cubic cage. Early results showed that this new technique has a comparable correction for treatment of planovalgus foot in CP with calcaneal lengthening. It may be preferable technique in patient with osteoporotic iliac bone and not available for allograft.

Results for "Foot and Ankle"