title: Return to sport activities after medial displacement calcaneal osteotomy and flexor digitorum longus transfer.
abstract: OBJECTIVE
  Medial displacement calcaneal osteotomy with flexor digitorum longus transfer is a common treatment for the management of the adult flatfoot associated with posterior tibial tendon dysfunction. In the literature, there is a paucity of information regarding the ability of patients to return to sport and recreational activities after this surgical procedure. The purpose of this retrospective clinical study was to assess the rate and type of athletic activities that patients participated in before and after medial displacement calcaneal osteotomy with flexor digitorum longus transfer.
  
  
  METHODS
  A consecutive series of 42 patients with a mean age at surgery of 41 years (range 19-74 years) was evaluated with a minimum follow-up of 24 months (range 18-31 months). Pre- and post-operative sporting activities were assessed. At final follow-up, patients were asked to complete a Sports Athlete Foot and Ankle Score (SAFAS). Each patient was also evaluated with weight-bearing radiographs of the foot before surgery and at final follow-up.
  
  
  RESULTS
  Preoperatively, 27 of 42 (64.3 %) patients were engaged in athletic activities, participating in an average of 1.4 h/week (range 0-6 h/week); post-operatively, 36/42 (85.7 %) participated in sport and recreational activities for an average of 3.5 h/week (range 0-15 h/week). Meary's angle improved significantly from 11.5 ± 6.2 degrees preoperatively to 7.0 ± 5.7 degrees at final follow-up (p < 0.01); calcaneal pitch improved significantly from 16.5 ± 4.6 degrees to 19.0 ± 5.0 degrees (p < 0.01). At final follow-up, patients demonstrated good SAFASs in symptom tolerance (86.4 %), pain tolerance (89.0 %), daily living performance (96.1 %), and sports performance (86.7 %).
  
  
  CONCLUSIONS
  The majority of patients returned to sports and recreational activity after medial displacement calcaneal osteotomy and flexor digitorum longus for the treatment of adult flatfoot associated with posterior tibial tendon dysfunction.
  
  
  METHODS
  III.
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. fusuelli@gmail.com.
authors.forename: F G
authors.initials: FG
authors.lastname: Usuelli
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.|Università degli Studi di Catania, Catania, Italy.
authors.forename: C A
authors.initials: CA
authors.lastname: Di Silvestri
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.|Università degli Studi di Milano, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: D'Ambrosi
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.|Università degli Studi di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Maccario
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: E W
authors.initials: EW
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005413:Flatfoot / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011184:Postoperative Period; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D000068958:Return to Sport / Q000502:physiology*; D013709:Tendon Transfer / Q000379:methods*; D055815:Young Adult
keywords: Calcaneal pitch; Flatfoot; Meary angle; Medial displacement calcaneal osteotomy; Posterior tibialis tendon dysfunction; Return to sport; Tendon transfer