@article{8610688,
  abstract     = {{Purpose: A medializing calcaneal osteotomy (MCO) is a surgical procedure frequently performed to correct an adult acquired flatfoot (AAFD) deformity. However, most studies are limited to a 2D analysis of 3D deformity. Therefore, the aim is to perform a 3D assessment of the hind- and midfoot alignment using a weightbearing CT (WBCT) preoperatively as well as postoperatively.
Methods: Eighteen patients with a mean age of 49.4years (range 18-67) were prospectively included in a pre-post-study design. A MCO was performed and a WBCT was obtained pre- and postoperative. Images were converted into 3D models to compute linear and angular measurements, respectively, in millimeters (mm) and degrees (degrees), based on previously reported landmarks of the hind- and midfoot alignment. A regression analysis was performed between the displacement of a MCO and the obtained postoperative correction.
Results: The mean 3D hindfoot angle improved significantly preoperative compared to postoperative (p<0.001). This appeared according to a linear relation with the amount of medial translation in a MCO (R-2=0.84, p<0.001). The axes of the tibia showed significant coronal as well as axial changes (p<0.05). Analysis of the midfoot showed significant changes in the navicular height and rotation as well as the Meary angle (p<0.05). Additionally, a linear trend between the midfoot measurements and amount of medial translation in a MCO was observed, but not significant (p>0.05).
Conclusion: This study demonstrates an effective 3D correction of an AAFD by a MCO according to a linear relationship. The concomitant formula can be used to perform a preoperative planning. The novelty is the comparative 3D weightbearing CT assessment of both the computed hind- and midfoot alignment after a medializing calcaneus osteotomy. This could improve accuracy of the currently performed preoperative planning in clinical practice.}},
  author       = {{Burssens, Arne and Barg, Alexej and van Ovost, Esther and Van Oevelen, Aline and Leenders, Tim and Peiffer, Matthias and Boderé, Irina and Audenaert, Emmanuel and Victor, Jan}},
  issn         = {{1861-6410}},
  journal      = {{INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY}},
  keywords     = {{Medializing calcaneal osteotomy,Computed pre- and postoperative assessment,Weightbearing CT,Adult acquired flatfoot deformity,FLATFOOT DEFORMITY,FOOT,TOMOGRAPHY,RECONSTRUCTION,POSITION,LONGUS,PEDCAT}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1439--1447}},
  title        = {{The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT}},
  url          = {{http://doi.org/10.1007/s11548-019-01949-7}},
  volume       = {{14}},
  year         = {{2019}},
}

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