title: Incidence of plantar lateral foot pain before and after the use of trial metal wedges in lateral column lengthening.
abstract: BACKGROUND
  One of the major concerns with lateral column lengthening (LCL) in symptomatic flatfoot deformity treatment is the risk of postoperative plantar lateral foot discomfort. We evaluated whether this risk can be minimized by using trial metal wedges. Using our study's evaluation tools, the incidence of postoperative plantar lateral foot discomfort before and after using trial metal wedges was determined.
  
  
  METHODS
  The incidence of planter lateral foot pain after LCL was retrospectively assessed in 122 consecutive patients (132 feet) after they had undergone flatfoot reconstruction with LCL between 2001 and 2007. To determine if the incidence could be reduced, levels of pain or revision were compared before and after the use of trial metal wedges. The ratio of wedge size to preoperative radiographic calcaneal length was also determined.
  
  
  RESULTS
  The overall incidence of plantar lateral discomfort was 11.2%. The incidence of pain or revision was lower after the introduction of trial metal wedges (6.3% compared to 14.7%), but did not reach significance (p = 0.084). There was no significant difference found in the ratio of the size of bone graft wedge to calcaneal length between the two groups (p = 0.805).
  
  
  CONCLUSIONS
  The incidence of plantar lateral foot discomfort overall was 11.2% after LCL. We believe this risk may be reduced using trial metal wedges, properly judging eversion stiffness and carefully assessing the position of the foot intraoperatively.
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. elliss@hss.edu
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Ellis
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Williams
authors.forename: Rohit
authors.initials: R
authors.lastname: Garg
authors.forename: Graham
authors.initials: G
authors.lastname: Campbell
authors.forename: Helene
authors.initials: H
authors.lastname: Pavlov
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Deland
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D011788:Quality of Life; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013525:Surgical Instruments
chemical_list: D008670:Metals