Our Summary

The research paper discusses a new method for treating a type of foot deformity known as acquired flatfoot. The condition is characterized by the collapse of the arch on the inside of the foot, specifically at the naviculocuneiform (NC) joint. One common treatment is a “triple fusion”, but this can lead to stiffness in the foot.

The researchers developed a method that combines two types of fusions - subtalar (ST) and NC - while keeping the Chopart joint intact. They tested this approach on 34 feet in 31 patients (23 women and 8 men, aged between 45 and 81). In some cases, additional adjustments were necessary to correct the alignment of the heel.

The researchers then measured various parameters on weight-bearing radiographs (a type of X-ray) before the surgery and again 2 years later. They found significant improvement in all parameters, except one related to the heel’s angle. Fusion was seen in nearly all cases (94.1%) after 1 year, with only two exceptions. One patient did develop a complication that required a total ankle replacement.

Overall, the patients were satisfied with the results. The researchers concluded that their method is effective and safe for treating adult acquired flatfoot where the arch collapses at the NC joint.

FAQs

  1. What is the new method developed for treating acquired flatfoot as discussed in the research paper?
  2. What were the findings of this research paper in terms of patient improvement and satisfaction after the surgery?
  3. What is the difference between the new method of fusion and the traditional “triple fusion”?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow post-operative care instructions carefully to ensure proper healing and optimal recovery. This may include physical therapy, wearing a brace or cast, and avoiding certain activities that could put stress on the fused joint. It is also important to attend follow-up appointments with your doctor to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended joint fusion for acquired flatfoot with collapse at the naviculocuneiform (NC) joint include:

  • Adults with acquired flatfoot deformity
  • Patients who have not responded to conservative treatments such as orthotics, physical therapy, and bracing
  • Those experiencing significant pain, instability, and difficulty walking due to the deformity
  • Individuals who have tried other surgical options such as triple fusion but experienced stiffness in the foot
  • Patients looking for a more flexible fusion option that can maintain some range of motion in the foot

It is important for patients to consult with their healthcare provider to determine if joint fusion is the appropriate treatment option for their specific condition.

Timeline

Before the joint fusion:

  1. Patient experiences pain, swelling, and difficulty walking due to acquired flatfoot.
  2. Patient undergoes imaging tests to confirm the diagnosis and assess the severity of the condition.
  3. Patient consults with a surgeon to discuss treatment options, including the possibility of joint fusion.
  4. Surgeon explains the procedure, risks, and benefits of joint fusion to the patient.
  5. Patient undergoes pre-operative preparation, which may include physical therapy and medical evaluations.

After the joint fusion:

  1. Patient undergoes the joint fusion surgery, which involves combining subtalar and NC fusions while preserving the Chopart joint.
  2. Patient may need additional adjustments to correct heel alignment during the surgery.
  3. Patient undergoes post-operative care, which includes pain management and rehabilitation.
  4. Patient undergoes follow-up appointments and imaging tests to monitor the fusion progress.
  5. Patient experiences significant improvement in pain and function, with fusion seen in the majority of cases after 1 year.
  6. Patient may experience complications, such as the need for total ankle replacement in rare cases.
  7. Patient reports satisfaction with the results of the joint fusion surgery.

What to Ask Your Doctor

  1. What is the success rate of joint fusion in treating my specific condition?
  2. What are the potential risks and complications associated with joint fusion surgery?
  3. How long is the recovery period following joint fusion surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How will joint fusion affect my mobility and range of motion in the affected joint?
  6. Are there any alternative treatments or procedures that could be considered instead of joint fusion?
  7. What is the long-term outlook for my condition after undergoing joint fusion surgery?
  8. What are the chances of needing additional surgery or interventions in the future?
  9. How soon can I expect to see improvements in my symptoms after joint fusion surgery?
  10. Are there any lifestyle modifications or precautions I should take post-surgery to ensure the best possible outcome?

Reference

Authors: Steiner CS, Gilgen A, Zwicky L, Schweizer C, Ruiz R, Hintermann B. Journal: Foot Ankle Int. 2019 Jan;40(1):42-47. doi: 10.1177/1071100718800295. Epub 2018 Oct 13. PMID: 30317867