Biomechanical effects on calcaneocuboid joint pressure after lateral column lengthening (Evans) procedure
ZHANG Feng, JIA Jiang, SHU Guang-Rong, DIAO Hong-Mou, YANG Yun-Feng
Chinese Journal of Clinical Anatomy ›› 2012, Vol. 30 ›› Issue (3) : 337-341.
Biomechanical effects on calcaneocuboid joint pressure after lateral column lengthening (Evans) procedure
Objective To study the pressure change across the calcaneocuboid joint after lateral column lengthening (Evans) procedure and the best width of the lateral column distraction, for providing information and reference for Evans osteotomy. Methods Six fresh-frozen cadaveric specimens of foot were randomized into 7 experimental groups: intact, flatfoot deformity model, Evans osteotomy to extend the lateral columns of different widths (from 4mm to 12mm, in 2-mm increments). Vertical downward axial loads of 350N were applied to the specimens, the calcaneocuboid joint pressures were measured by the K-Scan joint analysis system and K-Scan6900# Sensor Model. Results Under loads of 350N, the calcaneocuboid joint peak pressure were: intact group: (9.21±1.60), flatfoot deformity model group: (24.90±2.45), LCL*4mm group: (21.68±2.21), LCL*6mm group: (15.95±2.59), LCL*8mm group: (11.04±1.15), LCL*10mm group: (15.20±2.35) and LCL*12mm group: (21.55±2.03) kg/cm2, respectively. The calcaneocuboid joint peak pressure was significantly higher in the flatfoot than intact group（P＜0.05); after the different Evans osteotomy, the pressure has been significantly reduced in LCL groups than the flatfoot (P <0.05)；there was no significant difference in the calcaneocuboid joint peak pressure between LCL*8mm group and intact group (P=0.143); the pressure in LCL*8mm group was relatively smaller than the other lateral column lengthening groups (P<0.05). Conclusions Lateral column lengthening by means of an Evans osteotomy within a certain extent will decreases the pressure across the calcaneocuboid joint on the flatfoot deformity. The pressure is minimal at the 8 mm width of the lateral column distraction, and we consider it near the normal state.
Evans osteotomy / Calcaneocuboid joint / Flatfoot / Biomechanics
[1] Deland JT, Otis JC, Lee KT, et al. Lateral column lengthening with calcaneocuboid fusion: range of motion in the triple joint complex
[J]. Foot Ankle Int, 1995,16(11):729-733.
[2] Momberger N, Morgan JM, Bachus KN, et al. Calcaneocuboid pressure after lateral column lengthening in a cadaveric planovalgus deformity model
[J]. Foot Ankle Int, 2000, 21 (9):730-735.
[3] Tien TR, Parks BG, Guyton GP. Plantar pressures in the forefoot after lateral column lengthening: a cadaver study comparing the Evans osteotomy and calcaneocuboid fusion
[J]. Foot Ankle Int, 2005, 26(7):520-525.
[4] Sands A, Early J, Harrington RM, et al. Effect of variations in calcaneocuboid fusion technique on kinematics of the normal hindfoot
[J] . Foot Ankle Int， 1998, 19(1):19-25.
[5] Cooper PS, Nowak MD, Shaer J. Calcaneocuboid joint pressures with lateral column lengthening (Evans) procedure
[J]. Foot Ankle Int, 1997, 18(4):199-205.
[6] Vora AM，Tien TR，Parks BG, et al. Correction of moderate and severe acquired flexible flatfoot with medializing calcaneal osteotomy and flexor digitorum longus transfer
[J]. J Bone Joint Surg Am，2006, 88(8):1726-1734.
[7] Raines RA Jr, Brage ME. Evans osteotomy in the adult foot: an anatomic study of structures at risk
[J]. Foot Ankle Int，1998, 19(11):743-747.
[8] Philips GE. A review of elongation of oscalcis flatfeet
[J]．J Bone Joint Surg Br, 1983, 65(1): 15-18．
[9] Hintermann B, Valderrabano V, Kundert HP. Lengthening of the lateral column and reconstruction of the medial soft tissue for the treatment of acquired flat foot deformity associated with insufficiency of the posterior tibial tendon
[J]. Foot Ankle Int, 1999, 20(10):622-629.
[10] Speck M, Klaue K. Medial flexor digitorum longus tendon augmentation and lateral foot column lengthening or reorienting triple arthrodesis as surgical therapy of posterior tibial tendon dysfunction
[J]. Z Orthop Ihre Grenzgeb, 2001, 139(4):332-339.
[11] Haeseker GA, Mureau MA, Faber FW. Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis
[J]. J Foot Ankle Surg, 2010, 49(4):380-384.
[12] Dinucci KR, Christensen JC, Dinucci KA. Biomechanical consequences of lateral column lengthening of the calcaneus: Part I. long plantar ligament strain
[J]. J Foot Ankle Surg, 2004,43(1):10-15.
[13] Saxena A. Evans calcaneal osteotomy
[J]. J Foot Ankle Surg, 2000, 39(2):136-137.
/
| 〈 |
|
〉 |
