Calcaneocuboid distraction arthrodesis with allogenic bone grafting for correction of pes planovalgus

Published online: Oct 27 2013

Natalia GUTTECK, Susanne LEBEK, David WOHLRAB, Karl-Stefan DELANK, Alexander ZEH

From Martin Luther University, Halle Wittenberg, Germany


Calcaneocuboid distraction arthrodesis is regarded as an excellent and reliable surgical procedure for correction of pes planovalgus. Despite a potentially high complication rate, the use of an autologous iliac crest graft is regarded as the method of choice. In a prospective trial the results in 12 feet after calcaneocuboid distraction arthrodesis for pes planovalgus correction with allogenic bone graft were investigated. The mean age was 64 (52-81) years. An angle-stable plate was generally used for fixation of the arthrodesis. Successful bone healing was diagnosed clinically if local pain was absent during weight bearing, forefoot manipulation and palpation. The AOFAS score improved from 58.9 (± 6) points preoperatively to 89.8 (± 6,3) points 12 months postoperatively and the Visual Analogue Pain Scale (VAS) from 5.1 (± 1,4) to 0.7 (± 1) 12 months postoperatively. On radiological analysis, the lateral and dorsoplantar talometatarsal axis, hindfoot axis, the navicular floor distance and talonavicular coverage angle improved considerably. Bone fusion was observed in 11 of 12 cases postoperatively. In conclusion, the use of an allogenic graft for calcaneocuboid distraction arthrodesis did not result in a higher pseudarthrosis rate compared with results reported after use of an autologous iliac crest graft. Fixation with an angle-stable plate is recommended.