Abstract
Anterior calcaneal osteotomy (ACO) with extension bone graft is commonly employed
in the treatment of symptomatic supple, hypermobile flatfoot in adolescent as well
as adult (≥ 18 years of age) patients. Although autogenous bone graft has been considered
the gold standard, allogenic bone is widely used for this procedure because it is
readily available, requires no additional procedure for procurement and has incorporation
rates similar to autogenous bone graft. There is increasing agreement among surgeons
that the union rates with allograft bone are comparable with that observed with autograft
bone when used in the ACO. We reviewed the medical records of 51 consecutive patients
who had undergone 53 ACO with allogenic bone graft for the repair of flatfoot deformity
in an effort to further evaluate outcomes associated with the use of allogenic bone
graft. All of the patients had at least 12 months of follow-up. The mean time to graft
incorporation was 9.10 ± 1.54 weeks for adolescents and 9.81 ± 2.13 weeks for adults
(P = .0149), The incidence of graft incorporation (bone union) was 100% and 90% (P = .1391) in the adolescent and adult groups, respectively. Complications included
lateral column pain, sinus tarsitis, nonunion, calcaneocuboid capsulitis, complex
regional pain syndrome, incisional dehiscence, and sural neuritis; and all of the
complications occurred in the adult group. The results support the understanding that
ACO with allogenic bone graft is a reasonable alternative to autograft bone graft
in the treatment of flexible flatfoot in adolescent and adult patients.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: April 12, 2010
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
