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The Maxwell-Brancheau arthroereisis (MBA) implant is currently used in treating flexible
flatfoot deformities in children and adults. However, no guidelines have been established
to determine the degree of correction with the five different MBA implant sizes (6-,
8-, 9-, 10-, and 12-mm diameters). A biomechanical analysis of these implants was
performed in fresh-frozen cadaver limbs to quantitate the effects on subtalar joint
(STJ) motion restriction and radiographic angles. This study found a restriction of
subtalar joint range of motion that ranged from 32.0 ± 5.4%, 44.8 ± 7.7%, 59.0 ± 7.2%,
65.5 ± 8.7%, and 76.8 ± 7.6% restriction with successively larger sized implants respectively
(p < .001). Repeated measures analysis of variance (ANOVA) revealed alterations in
the first intermetatarsal, lateral talo-first metatarsal, talar declination, calcaneal
inclination, and first metatarsal declination angles with successively larger implant
use. Analysis of the dorsal talo-first metatarsal, talo-second metatarsal, lateral
talocalcaneal angles, and first to fifth metatarsal head splay showed no changes as
implant size was altered. The study also attempted to assess the effects on the tendo
Achillis when the subtalar joint was changed from a pronated to a supinated position.
The observations showed a 6.33 ± 1.40% (p = .001) increase in tendon length which
suggests increased tension to the tendon. These findings can aid the surgeon in selection
of the MBA implant size based on the desired amount of subtalar joint motion restriction.
In turn, this may reduce errors in the correction of flexible flatfoot with the MBA
implant.
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References
- Pes planovalgus in children.Clin. Orthop. 1983; 177: 133-139
- Flatfeet in children.Clin. Orthop. 1983; 181: 68-75
- Hypermobile flatfoot in children: comprehension, evaluation and treatment.Clin. Orthop. 1983; 181: 7-14
- Flatfoot overview.Clin. Podiatr. Med. Surg. 1989; 6: 477-489
- Symptomatic flatfoot: etiology and diagnosis.J. Am. Podiatry Assoc. 1983; 73: 393-399
- The diagnosis of flatfoot in the child.J. Bone Joint Surg. 1985; 67-B: 71-78
- Arthroereisis by means of subtalar polyethylene peg implant for correction of hindfoot pronation in children.Clin. Orthop. 1983; 181: 15-23
- Conservative treatment of flatfoot in the newborn.Clin. Podiatr. Med. Surg. 1989; 6: 521-536
- An operation for the correction of flexible flatfoot of adolescents.West. J. Surg. Obstet. Gynecol. 1946; 54: 77-86
- Medial arch support by operation: sustentaculum tali procedure.Orthop. Clin. North Am. 1973; 4: 117-144
- Surgical treatment of child's flatfoot.Clin. Orthop. 1992; 283: 34-38
- The MBA arthroereisis implant: early prospective results, ch. 42.in: Vickers N.S. Miller S.J. Mahan K.T. Reconstructive Surgery of the Foot and Leg. Podiatry Institute, Tucker, GA1997: 256-264
- Use of the Maxwell-Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction.Clin. Podiatr. Med. Surg. 1999; 16: 479-489
- An operative method for correction of certain forms of flatfoot.JAMA. 1923; 81: 1500-1507
- A plastic flatfoot operation.J. Bone Joint Surg. 1927; 9: 84
- An operation for the correction of extremely relaxed flatfeet.J. Bone Joint Surg. 1931; 13: 773-783
- Adult acquired flatfoot deformity.J. Bone Joint Surg. 1996; 78-A: 780-793
- A biomechanical analysis of flatfoot surgery.J. Am. Podiatry Assoc. 1973; 63: 217-236
- Subtalar arthroereisis: a four-year follow-up study.J. Am. Podiatry Assoc. 1983; 73: 356-361
- The Smith Sta-peg operation for hypermobile pes planovalgus in children.J. Am. Podiatr. Med. Assoc. 1985; 75: 177-183
- Calcaneal osteotomy for valgus and varus deformities of the foot in cerebral palsy: a preliminary report on twenty-seven operations.J. Bone Joint Surg. 1967; 49-A: 121-146
- Modified Hoke-Miller flatfoot procedure.Clin. Orthop. 1983; 181: 24-27
- Calcaneo-valgus deformity.J. Bone Joint Surg. 1975; 57-B: 270-278
- Treatment of mobile flatfoot by displacement osteotomy of the calcaneus.J. Bone Joint Surg. 1971; 53-B: 96-100
Additional references
- Foot alignment in the cerebral palsy patient.J. Bone Joint Surg. 1964; 46-A: 1-15
- The treatment of relapsed clubfoot by the insertion of a wedge into the calcaneum.J. Bone Joint Surg. 1963; 45-B: 55-67
- Correction of extreme flatfoot: value of osteotomy of os calcis and inward displacement of posterior fragment (gleich operation).JAMA. 1923; 81: 1502-1506
- Acquired flatfoot in adults.Clin. Orthop. 1983; 181: 46-51
- Calcaneal lengthening for valgus deformity of the hind-foot: results in children who had severe, symptomatic flatfoot and skewfoot.J. Bone Joint Surg. 1995; 77-A: 500-512
- The conservative treatment of adult flexible flatfoot.Clin. Podiatr. Med. Surg. 1989; 6: 555-560
Article info
Publication history
Accepted:
May 31,
2002
Received:
August 16,
2001
Identification
Copyright
© 2002 American College of Foot and Ankle Surgeons. All rights reserved. Published by Elsevier Inc. All rights reserved.
