Outcomes of spring ligament reconstruction for idiopathic flexible flatfoot deformity

Category: Hindfoot Introduction/Purpose: Idiopathic flatfeet are usually caused by attenuation of the medial soft tissues rather than a lateral osseous deficiency. Our prospective study aimed to quantify the functional and radiological outcome of a new technique for spring ligament reconstruction using a hamstring graft for idiopathic flat feet Methods: Our prospective study included 17 feet in 14 patients, from 05/14 to 05/17, on which a spring ligament reconstruction was performed. This pre-tensioned allograft reconstruction was performed using a blind talar tunnel, with the graft being passed deep to the navicular tuberosity, through a tunnel in the medial cuneiform and then sutured back onto its proximal limb to control abduction. Additional procedures included medial head of gastrocnemius recession (17), calcaneal osteotomy (16), FDL transfer (3), tibialis posterior synovectomy (2), peroneus longus to brevis transfer (2). There was a minimum of 6 months follow-up. Radiographic analysis was performed for standardised parameters. Paired t-test was used for analysis Results: The average age was 41 (range 23 -65). The mean BMI was 31.1 (range 24.6 – 37.3). Mearys line improved from a mean of 24.1 (9 – 36.4) to a mean of 13.8 (-3.1 – 26.7). This was statistically significant (p