Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction.
Flexor digitorum longus transfer and medial displacement calcaneal osteotomy is a well-recognised form of treatment for stage II posterior tibial tendon dysfunction. Although excellent short- and medium-term results have been reported, the long-term outcome is unknown. We reviewed the clinical outcome of 31 patients with a symptomatic flexible flat-foot deformity who underwent this procedure between 1994 and 1996. There were 21 women and ten men with a mean age of 54.3 years (42 to 70). The mean follow-up was 15.2 years (11.4 to 16.5). All scores improved significantly (p < 0.001). The mean American Orthopedic Foot and Ankle Society (AOFAS) score improved from 48.4 pre-operatively to 90.3 (54 to 100) at the final follow-up. The mean pain component improved from 12.3 to 35.2 (20 to 40). The mean function score improved from 35.2 to 45.6 (30 to 50). The mean visual analogue score for pain improved from 7.3 to 1.3 (0 to 6). The mean Short Form-36 physical component score was 40.6 (sd 8.9), and this showed a significant correlation with the mean AOFAS score (r = 0.68, p = 0.005). A total of 27 patients (87%) were pain free and functioning well at the final follow-up. We believe that flexor digitorum longus transfer and calcaneal osteotomy provides long-term pain relief and satisfactory function in the treatment of stage II posterior tibial tendon dysfunction.
OrtNorthern General Hospital, Herries Road, Sheffield, S5 7AU, UK.
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Chadwick
Orthopaedic Research Unit, Queensland University of Technology, Prince Charles Hospital, Rode Road, Chermside, Brisbane 4032, Australia.
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Whitehouse
Brisbane Foot and Ankle Centre, Level 7 Arnold Janssen Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane 4000, Australia.
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Saxby
D000328:Adult; D000368:Aged; D002111:Calcaneus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D037081:Posterior Tibial Tendon Dysfunction / Q000503:physiopathology / Q000601:surgery*; D013639:Tarsal Bones / Q000601:surgery; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome
calcaneal osteotomy; flexor digitorum longus transfer; posterior tibial tendon dysfunction