Evaluation of lateral column lengthening using autogenous fibular graft in the treatment of supple flat foot

Abstract

Background: Treatment options of flat foot vary from using orthosis to arthrodesis and the surgical procedure varies from soft-tissue operations till bony osteotomies. We hypothesized that the clinical, functional, and radiological outcomes of lateral calcaneal lengthening osteotomy using fibular graft in the treatment of symptomatic flatfoot are satisfactory. Materials and Methods: A prospective study was conducted involving 25 feet of 25 patients who underwent lateral calcaneal lengthening due to symptomatic flexible flat foot. All patients underwent clinical and radiological evaluation preoperatively and postoperatively, American Orthopedic Foot and Ankle Society (AOFAS) hindfoot/ankle scoring preoperatively and postoperatively. All patients underwent osteotomy of the calcaneus using a saw, after a satisfactory correction of the deformity obtained, autogenous fibular graft was inserted in the osteotomy site, and tendon Achilles lengthening was performed. Results: In our study, we had 25 patients, the average age was 11.48 years. There were 15 girls and 10 boys. The average AOFAS preoperative score was 68.56 ± 5. A 3-month postoperative. The average score was 86.40 ± 3.65. A final AOFAS hindfoot/ankle score at the time of maximal follow-up (average 21 months; range, 6–36 months) had an average score of 95.19 ± 1. A final AOFAS hindfoot/ankle score at the time of maximal follow-up (average 21 months; range, 6–36 months). Conclusion: Isolated lateral column lengthening using autogenous fibular graft was found to provide significant correction of all components of the supple pes planovalgus and forefoot abduction deformity. Level of Evidence: Level IV.