Emad Sanad Hussein Elsayed, Mohammed Osama Hegazy, Mahmoud Khairy Zaghloul and Mohamed Ahmed Abd Elbaky
Background: Flexible flatfoot (FFF) deformity is distinguished by the medial arch collapse, hindfoot valgus, forefoot abduction, and tightening of the gastrocnemius or gastrocnemius-soleus complex. The Z-osteotomy is a more current iteration of the Lateral Column Lengthening (LCL) and has promising results from existing research. This work aimed to evaluate the clinical and radiological results of double calcaneal Z osteotomy in symptomatic adolescent FFF patients.Methods: This prospective cohort study was conducted on 20 adolescent patients with FFF deformity, at Benha university Hospitals and Al Mahalla general hospital. All patients were subjected to clinical and radiological evaluation, general and local examination.
Results: The postoperative evaluation revealed significant improvements in the lateral cerebral palsy (CP). The preoperative mean lateral CP angle was 6.76° (SD 3.407), which increased to 23.40° (SD 6.377) postoperatively. This resulted in a mean improvement of -16.640° and a percentage change of 246.15%, with a statistically significant difference in means (t = -14.099, p< 0.001). Similarly, the lateral tarsometatarsal (TMT) angle showed significant improvement postoperatively compared to its preoperative measurement. The mean angle preoperatively was 11.616° (SD 5.627), which decreased to 1.091° (SD 0.637) postoperatively, resulting in a percentage change of 90.6%. A statistically significant was found (t = 10.525, p< 0.001).
Conclusion: The proposed technique has been demonstrated to be a valuable contribution to the surgical correction of symptomatic flexible flatfoot, as it is straightforward, corrects all components of the deformity in a single session, and can be conducted in a secure manner by adolescents.
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