Plantar pressures in patients with and without lateral foot pain after lateral column lengthening.
BACKGROUND
Lateral column lengthening, a commonly used adjuvant for the reconstruction of adult flatfoot deformity, can lead to postoperative complaints of lateral plantar pain or discomfort. We hypothesized that patients with such symptoms would have increased lateral plantar pressures when compared with matched controls without these symptoms.


METHODS
Ten subjects who had undergone lateral column lengthening and were experiencing pain or discomfort in the plantar-lateral aspect of the foot were selected. Controls who had undergone lateral column lengthening but who were not experiencing such symptoms were matched for age, sex, accessory reconstructive procedures, and time from surgery. At the time of the present study, the patients had been followed for at least two years after the reconstruction and had had removal of hardware. Radiographs of each foot were assessed before and after surgery. The patients completed the Short Form-36 (SF-36) and Foot and Ankle Outcome Score surveys, and standing plantar pressure measurements were obtained. Average mean pressure, peak pressure, and maximum force were assessed at twelve anatomic regions and the two groups were compared.


RESULTS
There were no significant preoperative differences between the two groups in terms of radiographic parameters. Patients with pain had significantly lower SF-36 Physical Health Summary scores (p < 0.05), SF-36 Physical Function Subscale scores (p < 0.05), and average Foot and Ankle Outcome Scores (p < 0.05). Patients with pain had significantly higher lateral midfoot average mean pressure (p < 0.05), peak pressure (p < 0.05), and maximum force (p < 0.05). No differences were found in the hindfoot or forefoot regions.


CONCLUSIONS
Patients who have undergone lateral column lengthening and who experience lateral plantar pain have increased plantar pressure values in the lateral aspect of the midfoot. The increased pressures in this area cannot be accounted for solely by radiographic or demographic factors.
Ellis
Scott Jacob
SJ
Department of Foot and Ankle Surgery, The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. elliss@hss.edu
Yu
Joseph C
JC
Johnson
A Holly
AH
Elliott
Andrew
A
O'Malley
Martin
M
Deland
Jonathan
J
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005413:Flatfoot / Q000601:surgery*; D005528:Foot / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology*; D011312:Pressure