Lateral column lengthening (LCL) using a rectangular shape graft for managing symptomatic flexible flatfoot showed acceptable early functional and radiological outcomes.

Abstract

We aimed to report the results of performing lateral column lengthening (LCL) using a rectangular-shaped graft to correct the flat foot deformity. A total of 28 feet of 19 patients (10 males, 9 females) having an average age of 10±3.2 years who were unresponsive to conservative management underwent flat foot deformity correction through LCL procedure supplemented with rectangular-shaped graft harvested from the fibula. Functional assessment was performed according to the American Orthopedic Foot and Ankle Society (AOFAS) scale. The radiographic assessment consisted of four parameters, Meary's angle in both anteroposterior (AP) and lateral (Lat.) views, calcaneal inclination angle (CIA), and calcaneocuboid angle (CCA). After an average of 30.2±8.1 months, the AOFAS improved significantly from 46.7±10.2 preoperatively to 86.7±9.5 at the last follow up (P<0.05). All the osteotomies showed healing at an average of 10.3±2.7 weeks. All the radiological parameters showed significant improvement at the last follow up compared to the preoperative measurements, CIA from 6.3±2.8-19.3±3.5, Lat. Meary's angle from 19.3±4.9-5.8±2.5, AP Meary's Angle from 19.3±5.8-6.1±3.1, and CCA from 23.9±8.2-6.8±4.5, (P<0.05). No pain at the site of the fibular osteotomy was reported in any of the patients. Lateral column lengthening using a rectangular graft effectively restores bony alignment with good radiological and clinical results, high patient satisfaction, and acceptable complications.