Talonavicular coverage angle correction in flat-abducted-foot after double calcaneal osteotomy

Abstract

Objective: To evaluate retrospectively through radiographic angular measurements, the correction of the talo-navicular subluxation in patients with flexible flat-abducted-feet undergoing medial sliding osteotomy of the calcaneus associated with lateral column lengthening with autologous bone graft from own calcaneus. Method: Measurements were made of the talo-navicular coverage angle on radiographs in orthostatic position, in anteroposterior and lateral planes. Images pre and postoperative of the 15 patients with flexible flat-abducted-foot symptomatic were analyzed, totaling 20 feet, which underwent medial sliding osteotomy and lengthening of the lateral column of the calcaneus with the use of autologous graft. The talo-navicular angle was measured by crossing the lines formed by the medial and lateral borders of the articular surface of the talus and navicular in weightbearing dorsoplantar radiograph. Results: The pre-operative measurements of the talo-navicular coverage angle ranging 10 to 50 degrees, with an average of 32 degrees, while the postoperative measurements ranged 2 to 30 degrees with an average of 11 degrees. The correction of the talo-navicular coverage angle ranged from 2 to 35 degrees, with an average of 19 graus. Conclusion: The double osteotomy of the calcaneus demonstrated to be an effective procedure for the correction of the talo-navicular coverage angle in symptomatic patients, restoring alignment of the medial column and enabling the alignment of the hindfoot in relation to the forefoot.