Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy
Background: Lateral column lengthening (LCL) for flexible flatfoot is an effective surgery with powerful correction of deformity because it tightens only the lateral third of the long plantar ligament (LPL). However, LCL has been associated with joint damage at the osteotomy site and loss of foot fl...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-10-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011420959651 |
| _version_ | 1818140044876054528 |
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| author | Masakazu Tazaki MD Takaaki Hirano MD, PhD Yui Akiyama MD, PhD Hiroyuki Mitsui MD, PhD Kazuaki Hirata MD, PhD Hisateru Niki MD, PhD |
| author_facet | Masakazu Tazaki MD Takaaki Hirano MD, PhD Yui Akiyama MD, PhD Hiroyuki Mitsui MD, PhD Kazuaki Hirata MD, PhD Hisateru Niki MD, PhD |
| author_sort | Masakazu Tazaki MD |
| collection | DOAJ |
| description | Background: Lateral column lengthening (LCL) for flexible flatfoot is an effective surgery with powerful correction of deformity because it tightens only the lateral third of the long plantar ligament (LPL). However, LCL has been associated with joint damage at the osteotomy site and loss of foot flexibility owing to joint fixation. We focused on the cuboid and investigate a novel anatomical LCL osteotomy site that effectively tightens the LPL without damaging any joints. Methods: We studied 24 feet of 12 cadavers (mean age, 80.8 years). The lengths of the LPL and short plantar ligament, locations of the attachments, and shape and location of the cuneocuboid joint on the medial side of the cuboid were studied. ImageJ software was used to measure the osteotomy angle. Results: The lateral cuboid attachment of the LPL on average was located 4.6 mm from the calcaneocuboid joint, and the cuneocuboid joint on average was located 6.7 mm from the cuboid-metatarsal joint on the medial surface of the cuboid. The direct line connecting the anterior cuneocuboid joint and the oblique crest of the cuboid on average was at a 10.3-degree inclination posterior to the cuboid-metatarsal joint. Conclusion: A straight line must be selected between a point 4 mm from the calcaneocuboid joint laterally and 6 mm from the cuboid-metatarsal joint medially at a 10-degree posterior tilt to the cuboid-metatarsal joint to perform a cuboid osteotomy LCL without damaging the articular surface. Clinical Relevance: We investigated a potential novel cuboid osteotomy method for LCL. |
| first_indexed | 2024-12-11T10:37:44Z |
| format | Article |
| id | doaj.art-337d467bbb0341cf9f53d60142cbf6c6 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-11T10:37:44Z |
| publishDate | 2020-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-337d467bbb0341cf9f53d60142cbf6c62022-12-22T01:10:40ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142020-10-01510.1177/2473011420959651Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid OsteotomyMasakazu Tazaki MD0Takaaki Hirano MD, PhD1Yui Akiyama MD, PhD2Hiroyuki Mitsui MD, PhD3Kazuaki Hirata MD, PhD4Hisateru Niki MD, PhD5 Shoseikai Tazaki Hospital, Orthopaedic Surgery, Tokyo, Japan Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan Department of Anatomy, St Marianna University School of Medicine, Kawasaki, Japan Department of Orthopedic Surgery, St. Marianna University School of Medicine, Kawasaki, JapanBackground: Lateral column lengthening (LCL) for flexible flatfoot is an effective surgery with powerful correction of deformity because it tightens only the lateral third of the long plantar ligament (LPL). However, LCL has been associated with joint damage at the osteotomy site and loss of foot flexibility owing to joint fixation. We focused on the cuboid and investigate a novel anatomical LCL osteotomy site that effectively tightens the LPL without damaging any joints. Methods: We studied 24 feet of 12 cadavers (mean age, 80.8 years). The lengths of the LPL and short plantar ligament, locations of the attachments, and shape and location of the cuneocuboid joint on the medial side of the cuboid were studied. ImageJ software was used to measure the osteotomy angle. Results: The lateral cuboid attachment of the LPL on average was located 4.6 mm from the calcaneocuboid joint, and the cuneocuboid joint on average was located 6.7 mm from the cuboid-metatarsal joint on the medial surface of the cuboid. The direct line connecting the anterior cuneocuboid joint and the oblique crest of the cuboid on average was at a 10.3-degree inclination posterior to the cuboid-metatarsal joint. Conclusion: A straight line must be selected between a point 4 mm from the calcaneocuboid joint laterally and 6 mm from the cuboid-metatarsal joint medially at a 10-degree posterior tilt to the cuboid-metatarsal joint to perform a cuboid osteotomy LCL without damaging the articular surface. Clinical Relevance: We investigated a potential novel cuboid osteotomy method for LCL.https://doi.org/10.1177/2473011420959651 |
| spellingShingle | Masakazu Tazaki MD Takaaki Hirano MD, PhD Yui Akiyama MD, PhD Hiroyuki Mitsui MD, PhD Kazuaki Hirata MD, PhD Hisateru Niki MD, PhD Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy Foot & Ankle Orthopaedics |
| title | Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy |
| title_full | Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy |
| title_fullStr | Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy |
| title_full_unstemmed | Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy |
| title_short | Anatomical Study of the Cuboid and Its Ligamentous Attachments and Its Implications for a Cuboid Osteotomy |
| title_sort | anatomical study of the cuboid and its ligamentous attachments and its implications for a cuboid osteotomy |
| url | https://doi.org/10.1177/2473011420959651 |
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