Symptomatic flatfoot is a prevalent disorder. We undertook a review of 50 feet in 39 patients with flexible flatfoot treated between August 2000 and January 2008 in order to evaluate the modified Kidner-Cobb procedure. Overall clinical results were rated as good in 48 (96%) feet and fair in 2 (4%) feet, and there were no poor results. Average follow-up was 4.6 years, and total recovery time was 5.7 months in older patients and 3.7 months in children. Manual muscle-strength testing revealed no difference in tibialis anterior strength between the operated and contralateral extremity. All patients visually demonstrated postoperative elevation of the medial longitudinal arch height. Complications included 2 feet with wound dehiscence and 1 foot with fractured hardware. The results of this review indicate that the modified Kidner-Cobb procedure is a useful treatment option for patients with symptomatic flexible flatfoot with posterior tibial tendon dysfunction stage 2.
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- Flexible flatfoot treatment with arthroereisis: radiographic improvement and child health survey analysis.J Foot Ankle Surg. 2004; 43: 144-155
- Biomechanics of procedures used in adult flatfoot deformity.Foot Ankle Clin. 2001; 6: 15-23
- Combined technique for surgical correction of the pediatric severe flexible flatfoot.J Foot Ankle Surg. 1995; 34: 183-194
- The cavovarus foot (medial peritalar subluxation).in: Hansen S.T. Functional Reconstruction of the Foot and Ankle, p 211. Lippincott Williams & Wilkins, Philadelphia2000
- Possible epidemiological factors associated with rupture of posterior tibial tendon.Foot Ankle. 1992; 13: 70-79
- Current concepts review: acquired flatfoot in adults due to dysfunction of the posterior tibial tendon.J Bone Joint Surg. 1999; 81A: 1173-1182
- Use of the Cobb procedure in the treatment of posterior tibial tendon dysfunction.Clin Podiatr Med Surg. 2002; 19: 371-389
- Treatment of mobile flatfoot by displacement osteotomy of the calcaneus.J Bone Joint Surg. 1971; 53B: 96-100
- Kidner procedure for symptomatic accessory navicular and its relationship to pes planus.Foot Ankle. 1995; 16: 500-503
- The pre hallux (accessory scaphoid) in its relationships to the flat foot.J Bone Joint Surg. 1929; 11: 831-837
- The relationship of the accessory navicular to the development of the flatfoot.Clin Orthop. 1979; 144: 233-237
- The symptomatic accessory navicular bone.J Fam Pract. 1982; 15: 59-64
- An operative method for the correction of certain forms of flatfoot.JAMA. 1923; 81: 1500-1502
- The Cobb procedure for stage II posterior tibial tendon dysfunction.Clin Podiatr Med Surg. 1999; 16: 471-473
- Cobb repair for tibialis posterior tendon rupture.J Foot Surg. 1990; 29: 349-352
- Posterior tibial tendon rupture: classification, modified surgical repair, and retrospective study.J Foot Ankle Surg. 1993; 32: 2-13
- Outcomes for surgical correction for stages II and III tibialis posterior dysfunction.J Foot Ankle Surg. 1998; 37: 467-471
- The Cobb procedure for treatment of acquired flatfoot deformity associated with stage II insufficiency of the posterior tibial tendon.Foot Ankle Int. 2007; 28: 416-421
- Pathologic pes valgus disorders.in: Banks A.S. Downey M.S. Martin D.E. Miller S.J. McGlamry's Comprehensive Textbook of Foot and Ankle Surgery. Lippincott Williams & Wilkins, Philadelphia2001: 869-879
- Acquired adult flatfoot secondary to stage I posterior tendon pathology.J Bone Joint Surg. 1986; 68A: 95-102
- Rupture of the posterior tibial tendon: CT and surgical findings.Radiology. 1988; 176: 489-493
- Tibialis posterior tendon dysfunction.Clin Orthop. 1989; 239: 196-206
- Clinical significance of magnetic resonance imaging in preoperative planning for reconstruction of posterior tibial tendon ruptures.Foot Ankle. 1992; 13: 208-214
- Special Report series no 282. Her Majesty's Stationary Office, London1954
- The nervous system.in: Bates B. A Guide to Physical Examination and History Taking. J.B. Lippincott Company, Philadelphia1987: 490
- Computer face scale for measuring pediatric pain and mood.J Pain. 2008; 10: 173-179
- Acquired flatfoot secondary to tibialis posterior dysfunction: biomechanical aspects.J Foot Surg. 1991; 30: 2-11
- Subtalar arthroereisis: a combined technique.J Foot Surg. 1988; 27: 157-161
- Subtalar arthroereisis as adjunct treatment for type II posterior tibial tendon deficiency.Tech Foot Ankle Surg. 2006; 5: 117-125
- Surgical treatment of flexible flatfoot in children.J Bone Joint Surg Am. 2001; 83-A: 73-79
- Instructional Course Lectures, The American Academy of Orthopaedic Surgeons—Adult Acquired Flatfoot Deformity. Treatment of Dysfunction of the Posterior Tibial Tendon.J Bone Joint Surg Am. 1996; 76: 780-792
- A new operative approach for flatfoot secondary to posterior tibial tendon insufficiency: a preliminary report.Foot Ankle. 1997; 18: 206-212
- Double calcaneal osteotomy in the treatment of posterior tibial tendon dysfunction.J Foot Ankle Surg. 1995; 34: 254-261
- Adult flatfoot/posterior tibial tendon dysfunction: outcomes analysis of surgical treatment utilizing an algorithmic approach.J Foot Ankle Surg. 2000; 39: 359-364
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Conflict of Interest: None reported.
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