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Randomized Controlled Trial
. 2021 Oct;45(10):2579-2588.
doi: 10.1007/s00264-021-05172-5. Epub 2021 Aug 20.

Comparison between Malerba osteotomy and combined Evans/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: a prospective randomised control trial, three years follow-up

Mohamed Nagy  1   2   3 , Ahmed Kholeif  4 , Ali M Reda Mansour  4 , Samar Abdelhameed  5 , Yasser A Radwan  4 , Ahmed Khedr  4 , Ahmed S Elhalawany  4 , Ahmed Samir  4 , Islam Sarhan  6 , Abo Bakr Zein  4
Affiliations
Randomized Controlled Trial

Comparison between Malerba osteotomy and combined Evans/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: a prospective randomised control trial, three years follow-up

Mohamed Nagy et al. Int Orthop. 2021 Oct.

Abstract

Purpose: The aim of the current study is to evaluate the functional and radiological outcomes of Malerba osteotomy in comparison to the standardized combined Evans/Medial Displacement Calcaneal Osteotomy (MDCO) in the management of symptomatic flexible pes planus in young adults.

Methods: Prospective randomized control trial included 34 feet (33 patients), 17 cases in each group. Functionally, patients were assessed by AOFAS and FADI scores. Radiographic evaluation included calcaneal pitch, lateral talo-1st metatarsal, AP talo-first metatarsal, AP talo-calcaneal angles, and the talar coverage percentage.

Results: Pre-operative and three years follow-up scores and angles were compared between both groups. No statistically significant difference could be detected between both groups (P value 0.87). However, the data showed statistically significant difference in each group when comparing (pre-operative and third year follow-up scores and angles) (P value < 0.001). The mean union rate was eight weeks in Malerba group and nine weeks in Evans/MDCO group. No incidence of nonunion. Complications like calcaneocuboid subluxation, calcaneal anterior process fracture, and lateral column pain were exclusively reported in Evans/MDCO group.

Conclusion: Malerba osteotomy is a strong valid option for the operative management of flexible pes planus in young adults. Authors recommend Malerba osteotomy in all mild and moderate deformities due to lower complication rate while the combined Evans/MDCO is preferred in severe deformity due to relatively higher corrective power with consideration of possible complications.

Keywords: Combined Evans/MDCO; Flexible pes planus; Functional and radiological assessment; Malerba osteotomy; Young adults.

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