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Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity.

Publication ,  Journal Article
Abousayed, MM; Coleman, MM; Wei, L; de Cesar Netto, C; Schon, LC; Guyton, GP
Published in: Foot Ankle Int
November 2021

BACKGROUND: We investigated the long-term radiographic outcomes of the Cotton osteotomy performed at our institution by the 2 senior authors in conjunction with other reconstruction procedures to correct adult-acquired flatfoot deformity (AAFD). METHODS: We retrospectively studied patients who underwent Cotton osteotomy between 2005 and 2010 with minimum 4-year follow-up. Radiographic assessment was made on weightbearing radiographs taken at 4 different time intervals: preoperative, early (first postoperative full weightbearing), intermediate (between 1 and 4 years postoperatively), and final (over 4 years postoperatively). RESULTS: Nineteen patients were included. Final follow-up was 8.6 ± 2.6 years. The lateral talus-first metatarsal angle improved significantly from preoperative to early radiographs (n = 15; mean change: 30 degrees, 95% CI, 21.6-38.7; P < .0001). A significant loss of correction was observed between intermediate and final radiographs (n = 11; mean change: 17 degrees, 95% CI, 8.1-26.4; P < .0001). Of 14 patients with early radiographs, 8 lost >50% of the correction initially achieved. Medial column height decreased by 3.0 mm (95% CI, 1.80-7.90; P = .35) between early radiographs and final follow-up. DISCUSSION: This is the longest reported radiographic follow-up of the Cotton osteotomy performed to address forefoot varus deformity as part of AAFD. The Cotton osteotomy achieved radiographic correction of the medial longitudinal arch at early follow-up, but approximately half of the patients had lost over 50% of that correction at final follow-up. The lengthened angular shape of the cuneiform did not collapse, implying that further collapse occurred through the medial column joints. LEVEL OF EVIDENCE: Level IV, case series.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2021

Volume

42

Issue

11

Start / End Page

1384 / 1390

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiography
  • Osteotomy
  • Orthopedics
  • Humans
  • Foot Deformities, Acquired
  • Flatfoot
  • Adult
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
 

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Abousayed, M. M., Coleman, M. M., Wei, L., de Cesar Netto, C., Schon, L. C., & Guyton, G. P. (2021). Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity. Foot Ankle Int, 42(11), 1384–1390. https://doi.org/10.1177/10711007211015175
Abousayed, Mostafa M., Michelle M. Coleman, Lawrence Wei, Cesar de Cesar Netto, Lew C. Schon, and Gregory P. Guyton. “Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity.Foot Ankle Int 42, no. 11 (November 2021): 1384–90. https://doi.org/10.1177/10711007211015175.
Abousayed MM, Coleman MM, Wei L, de Cesar Netto C, Schon LC, Guyton GP. Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity. Foot Ankle Int. 2021 Nov;42(11):1384–90.
Abousayed, Mostafa M., et al. “Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity.Foot Ankle Int, vol. 42, no. 11, Nov. 2021, pp. 1384–90. Pubmed, doi:10.1177/10711007211015175.
Abousayed MM, Coleman MM, Wei L, de Cesar Netto C, Schon LC, Guyton GP. Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity. Foot Ankle Int. 2021 Nov;42(11):1384–1390.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

November 2021

Volume

42

Issue

11

Start / End Page

1384 / 1390

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiography
  • Osteotomy
  • Orthopedics
  • Humans
  • Foot Deformities, Acquired
  • Flatfoot
  • Adult
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science