First-Ray Radiographic Changes After Flexible Adult Acquired Flatfoot Deformity Correction

• Published in: Foot & ankle international 2022-01, Vol.43 (1), p.55-65
• Main Authors: Wang, Chien-Shun, Tzeng, Yun-Hsuan, Yang, Tzu-Cheng, Lin, Chun-Cheng, Chang, Ming-Chau, Chiang, Chao-Ching
• Format: Article
• Language: English
• Subjects: Adult; Flatfoot - diagnostic imaging; Flatfoot - surgery; Foot Deformities, Acquired; Hallux Valgus - diagnostic imaging; Hallux Valgus - surgery; Humans; Metatarsal Bones; Osteotomy; Retrospective Studies
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/10711007211034516

Background: Adult acquired flatfoot deformity (AAFD) and hallux valgus (HV) are common foot and ankle deformities. Few studies have reported the changes in radiographic parameters of HV after reconstructive surgery for AAFD. This study aimed to evaluate the changes in radiographic parameters of HV and analyze the risk factors for increased HV after correction of AAFD. Methods: Adult patients with flexible AAFD who underwent similar bony procedures including medializing calcaneal osteotomy and Cotton osteotomy were included. Radiographic parameters were measured on weightbearing radiographs preoperatively, postoperatively, and at the final follow-up. Patients were divided into hallux valgus angle (HVA) increased and HVA nonincreased groups; logistic regression analysis was performed to identify risk factors affecting increased HV. Results: Forty-six feet of 43 patients were included. After AAFD reconstructive surgery, the tibial sesamoid position improved by 1 grade, but the HVA increased 4 degrees in average. Further, 21 of 46 feet (46%) showed an HVA increase ≥5 degrees immediately after AAFD correction surgery. Preoperative talonavicular coverage angle