gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Static and dynamic hindfoot alignment in ankle and TTC arthrodesis

Meeting Abstract

  • A. Frigg - Universitätsspital Basel, Behandlungszentrum Bewegungsapparat, Basel, Switzerland
  • B. Nigg - University of Calgary, Human Performance Laboratory, Calgary, Canada
  • H. Dougall - University of Calgary, Orthopaedic Department, Calgary, Canada
  • I. Russell - University of Calgary, Orthopaedic Department, Calgary, Canada
  • V. Valderrabano - Universitätsspital Basel, Behandlungszentrum Bewegungsapparat, Basel, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN19-409

DOI: 10.3205/10dkou116, URN: urn:nbn:de:0183-10dkou1163

Published: October 21, 2010

© 2010 Frigg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: The Saltzman hindfoot alignment view (HAV) is considered the gold standard for assessing the axis from hindfoot to tibia. However, it is unclear how static alignment influences dynamic alignment during gait. This study aimed at evaluating the static and dynamic hindfoot alignment in ankle (AA) and tibiotalocalcaneal (TTC) arthrodesis.

Methods: 98 patients (AA=56, TTC=42) with an average follow-up of 4.1±1.3 years were assessed clinically with AOFAS- and SF-36 scores, visual hindfoot alignment, HAV, dynamic pedobarography using a 5-step method and a mask with 11 divisions (novel emed m/e). For comparison, 70 normal feet were evaluated.

Results and conclusions: The HAV-angle was –0.75±7.83 degrees for ankle, –1.19±6.92° for TTC arthrodesis. Visual alignment only predicted the corresponding HAV-angle in 48%. The HAV-angle had significant correlations to several final pedobarographic load parameters (r=0.35–0.53, p=0.02 to <0.0001). Static alignment did not influence subjective outcome. To reproduce the dynamic load pattern of normal subjects, an HAV-angle of 0 to >10° of valgus was needed.

Intra-operative positioning of the hindfoot by visual means resulted in a relatively large standard deviation of ±7–8° and a slight varus position. Visual judgment was not accurate enough as it only corresponded to the HAV-angle in 48%. The static alignment had a strong correlation to the dynamic load pattern; however, it did not influence subjective outcome. To reproduce the dynamic load pattern of normal subjects, a neutral to >10° of valgus position was needed in the HAV.