Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Introduction: Symptomatic flatfoot patients should be early and properly managed to improve the functional outcome throughout their lives.The aim of the current study is to evaluate the functional and radiographic results of the lateral column lengthening by plate fixation without bone graft in the management of the symptomatic flexible flatfoot. Patients and Methods: The current study included 30 feet (27patients) underwent lateral column lengthening by plate fixation without bone graft. Radiographic evaluation included calcaneal pitch angle, lateral talo-1st metatarsal angle, lateral talo-calcaneal angle, antero-posterior (AP) talo-1stmetatarsal angle, and talar coverage angle. The functional assessment was done using the American Orthopeadic Foot and Ankle Society (AOFAS) score. Results: The mean follow-up was 16.5 ± 3.027 months. There was marked improvement and statistically significant difference between pre and one year post-operative functional scoresand radiological angles. The mean AOFAS score was improved from 51.6 ±6.75 to 92.2 ±6.21. The mean AP Talo-1st M angle was improved from 25.3 ± 8.31 to 3.4 ± 5.10. The mean AP talo-navicular coverage wasimproved from 22.10 ±4.28 to 2.3 ± 3.46. The mean Lat. Talo-1st M angle wasimproved from 18.6 ± 4.79to 3.3 ± 3.16. The Calc. pitch angle wasimproved from 9.6 ± 4.14 to 15.1 ± 4.43. The mean lateral Talo-Calc. angle wasimproved from 45.7 ± 3.77 to 37.5 ± 3.47.Regarding the complications,superficial skin infection occurred in 3 cases, Symptomatic hardware in 4 cases, Lateral column pain occurred in 2 cases at the calcaneocuboid joint. Fracture of middle facet intraoperatively occurred in one case

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