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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EAdult flatfoot deformity is often treated surgically with subtalar arthroereisis or lateral column lengthening. In a study that evaluated clinical and radiographic outcomes among 18 patients who underwent either procedure, no significant differences in radiographic outcomes were evident at 18 months, although the subtalar arthroereisis group had significantly higher SF-36 Health Survey Update scores.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eadult flat foot\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esubtalar arthroereisis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elateral column deformity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESF-36 Health Survey Update\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eradiographic measurements\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Efoot \u0026amp; ankle conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopedic procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003EAdult flatfoot deformity is a progressive condition that causes flattening or collapse of the arch of the foot and is characterized by pain and difficulty managing daily activities. Although damage to the posterior tibial tendon is the most common cause, other contributing factors include arthritis, injury, and Charcot foot. Among patients who have a flexible\u2014as compared to rigid\u2014arch collapse, surgery can often help improve pain and walking ability.\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003ETwo commonly performed adult flatfoot procedures include subtalar arthroereisis (SA) and lateral column lengthening (LCL). During the SA procedure, an implant is placed below the talus to stabilize the subtalar joint by limiting excessive pronation and preserving varus range of motion. LCL allows surgeons to create a higher arch by realigning the calcaneus.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003ETo evaluate whether one procedure might offer better repair than the other, Lee Bing Howe, MD, Yong Loo Lin School of Medicine, Singapore, described outcomes from a study that compared clinical and radiographic outcomes of the two surgeries. Eighteen consecutive patients (11 men, 7 women) with adult stage II flexible flatfoot deformity were randomized to surgical treatment with either LCL (n\u2005=\u20059) or SA (n\u2005=\u20059) performed by a senior surgeon. All patients also underwent a concomitant endoscopic gastrocnemius recession procedure, a medializing calcaneal osteotomy, and a modified Kidner procedure. LCL procedures were performed using an 8-mm wedge plate; SA was performed using a size 10-mm implant. The average age at the time of surgery was comparable in the LCL (30.8 years) and SA (31.7 years) groups.\u003C\/p\u003E\n\u003Cp id=\u0022p-5\u0022\u003EClinical outcomes were measured using pre- and postoperative American Orthopaedic Foot \u0026amp; Ankle Society (AOFAS) Ankle-Hindfoot Scale and the SF-36 Health Survey Update (SF-36) scores at 3, 6, 12, and 18 months. Radiographic measurements were assessed using 10 parameters on the anteroposterior (AP) and lateral weight-bearing radiographs at 6 and 18 months. The minimum length of follow-up was 18 months.\u003C\/p\u003E\n\u003Cp id=\u0022p-6\u0022\u003EAt the time of the final follow-up, only patients in the SA group showed significant improvement in SF-36 scores (\u003Cem\u003EP\u2005\u003C\/em\u003E\u0026lt;\u2005.05). Postoperative AOFAS scores showed significant improvements in both groups (LCL group, \u003Cem\u003EP\u2005\u003C\/em\u003E=\u2005.038; SA group, \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.008).\u003C\/p\u003E\n\u003Cp id=\u0022p-7\u0022\u003EAt 18 months, both groups showed significant improvements (\u003Cem\u003EP\u2005\u003C\/em\u003E\u0026lt;\u2005.05) in 5 of the 10 radiologic parameters measured: (1) talus\u2013first metatarsal angle (AP), (2) talus\u2013first metatarsal angle (lateral), (3) calcaneal pitch angle (lateral), (4) talonavicular uncoverage angle (AP), and (5) and medial column height (lateral).\u003C\/p\u003E\n\u003Cp id=\u0022p-8\u0022\u003EAccording to Prof Howe, these data suggest that in adults with flexible flatfoot deformity, the SA procedure is similarly effective for the LCL as measured clinically and radiographically. However, he cautioned that it will be important to monitor how long the correction ultimately persists before the overall effectiveness of the procedure can be determined.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/14.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlq3e\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}