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Papers of the Week

2020 Aug 27

Foot Ankle Int

Consensus for the Indication of Lateral Column Lengthening in the Treatment of Progressive Collapsing Foot Deformity.


Thordarson D, Schon LC, de Cesar Netto C, Deland JT, Ellis SJ, Johnson JE, Myerson MS, Sangeorzan BJ, Hintermann B
Foot Ankle Int. 2020 Aug 27:1071100720950732.
PMID: 32851858.


Progressive collapsing foot deformity (PCFD) is a complex 3D deformity with varying degrees of hindfoot valgus, forefoot abduction, and midfoot supination. Although a medial displacement calcaneal osteotomy can correct heel valgus, it has far less ability to correct forefoot abduction. More severe forefoot abduction, most frequently measured preoperatively by assessing talonavicular coverage on an anteroposterior (AP) weightbearing conventional radiographic view of the foot, can be more effectively corrected with a lateral column lengthening procedure than by other osteotomies in the foot. Care must be taken intraoperatively to not overcorrect the deformity by restricting passive eversion of the subtalar joint or causing adduction at the talonavicular joint on simulated AP weightbearing fluoroscopic imaging. Overcorrection can lead to lateral column overload with persistent lateral midfoot pain. The typical amount of lengthening of the lateral column is between 5 and 10 mm.