Results of calcaneocuboid distraction arthrodesis.
BACKGROUND
One powerful method of reconstructing an adult acquired flatfoot deformity is a calcaneocuboid distraction arthrodesis. We performed a retrospective review of a small series of patients who underwent a calcaneocuboid distraction arthrodesis with a femoral head allograft.


METHODS
Sixteen feet (14 patients) were identified with an average follow up of 23 months (8-39 months) and an average age of 43 years (16-60 years). A calcaneocuboid distraction arthrodesis was performed with a femoral head allograft, secured with a 3 hole 1/3 tubular plate with 7 of the grafts being supplemented with platelet rich plasma (PRP). Patients were kept non-weight bearing for 6 weeks with an additional 6 weeks in a walking cast or boot. Plain radiographs and if necessary a CT or MRI were used to evaluate for union.


RESULTS
Seven of the 16 feet developed a nonunion. Five of 9 patients without PRP developed a nonunion vs 2 of 7 patients where PRP was used.


CONCLUSIONS
Due to the unacceptably high complication rate with this procedure, the authors have abandoned this procedure. If an allograft is to be used for a calcaneocuboid arthrodesis, the authors strongly recommend using rigid locking fixation with a longer period of protected immobilization.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1200 N. State St, GNH 3900, Los Angeles, CA 90033, USA. grunande@usc.edu
Todd R
TR
Grunander
David B
DB
Thordarson
D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D001860:Bone Plates; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000601:surgery; D005413:Flatfoot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D010027:Osteotomy / Q000379:methods; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013639:Tarsal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult