Relieve Health Group

Relieve Health Group

The human foot is a complex structure, made up of 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. One of the most intricate joints in this structure is the ankle joint, which plays a crucial role in our ability to walk, run, and jump. However, certain deformities can affect the functionality of the ankle joint, leading to pain and mobility issues. One such deformity is the ball and socket ankle deformity, which is usually congenital and asymptomatic. However, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis.

To address this issue, a study was conducted to evaluate the clinical and radiologic outcomes of a surgical procedure known as ankle fusion combined with calcaneal sliding osteotomy. This procedure was performed on patients with severe arthritic ball and socket ankle deformity.

The study followed 14 patients for more than 3 years after the operation. The evaluation of the procedure’s effectiveness was based on several factors. These included the American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. Additionally, the period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically.

The results of the study were promising. The AOFAS and FAAM scores, which measure the functionality of the foot and ankle, were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. The VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. This indicates a substantial reduction in pain experienced by the patients.

The average satisfaction score of patients was 88.9 points, suggesting a high level of satisfaction with the procedure. The difference in heel alignment angle (compared to the contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. This indicates a significant correction in the alignment of the foot, which can improve gait and reduce the risk of further injury.

However, the study also reported some complications. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion. Despite these complications, the study concluded that ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis.

This procedure provides reliable pain relief and restoration of gait ability through correcting hindfoot malalignment, which can significantly improve the quality of life for patients suffering from this condition. However, it’s important to note that this study is a Level IV, retrospective case series. This means that while the results are promising, more research is needed to confirm these findings and to further refine the procedure to reduce the risk of complications.

In conclusion, the study provides valuable insights into the potential benefits of ankle fusion combined with calcaneal sliding osteotomy for patients with severe arthritic ball and socket ankle deformity. It highlights the importance of innovative surgical techniques in improving the quality of life for patients with complex foot and ankle conditions. However, it also underscores the need for further research to ensure the safety and effectiveness of these procedures.

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