Functional limitations after lateral column lengthening osteotomy of the calcaneus are associated with lower quality of
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ORIGINAL PAPER
Functional limitations after lateral column lengthening osteotomy of the calcaneus are associated with lower quality of life Corina Nüesch 1,2,3 & Anna Katharina Schmid 1 & S. Kimberly Byrnes 1 & Philipp Krenn 1 & Monika Horisberger 1 & Annegret Mündermann 1,2,3 & André Leumann 4 Received: 14 November 2019 / Accepted: 4 March 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to quantify limitations in sagittal ankle range of motion (ROM) at least two years after lateral column lengthening osteotomy of the calcaneus (LLC) and their implications regarding quality of life. Methods Fifteen patients with a mean follow-up of 80 ± 27 months after LLC and 15 age-matched healthy persons participated in this study. Ankle joint complex ROM in plantarflexion and dorsiflexion was measured bilaterally using a goniometer and fluoroscopy (patients only). Quality of life was assessed using the short-form health questionnaire (SF36). Differences in ROM parameters (for the tibiotalar and subtalar joint) between sides (affected vs. unaffected) and between groups (patient vs. controls) and the relationship between ROM parameters and quality of life scores were assessed. Results ROM of the ankle joint complex on the affected side in patients was smaller than on the contralateral side (goniometer and fluoroscopy) and in healthy persons (goniometer; all P < .05). Among patients, SF36 total and pain scores, respectively, correlated with ROM of the subtalar joint (fluoroscopy; R = 0.379, P = 0.039 and R = 0.537, P = 0.001). Among patients and healthy persons, those with smaller dorsiflexion (goniometer) had lower quality of life scores. Conclusions The smaller sagittal ROM of the affected ankle joint complex compared with the contralateral foot and healthy controls was mainly explained by limitations in the tibiotalar joint. Because of its association with quality of life, ROM should be considered in the treatment and rehabilitation planning in patients who are candidates for LLC. Keywords Flat foot deformity . Corrective surgery . Range of motion . Quality of life
Introduction Patients with adult acquired flatfoot deformity present with pain and functional limitations [1–3]. The reported prevalence Corina Nüesch and Anna Katharina Schmid share first authorship of this article Level of Evidence: Level III, retrospective cohort study * Annegret Mündermann [email protected] 1
Department of Orthopedics and Traumatology, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland
2
Department of Biomedical Engineering, University of Basel, Basel, Switzerland
3
Department of Clinical Research, University of Basel, Basel, Switzerland
4
OrthoPraxis Leumann, Basel, Switzerland
is 3.3% in middle-aged women over 40 years of age [4]. Stage II is characterized by flexible hindfoot valgus, forefoot abduction and limited ability for single-leg heel rises [5, 6] and can be treated surgically by correcting the hindfoot position with calcaneal osteotomies. Several techniques such as medial
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