I'm scheduled to have a foot reconstruction with calcaneal osteotomies with lateral column lengthening. I know what the calcaneal osteotomy is but can anyone help explain teh lateral column lengthening. What is the lateral column and what do they lenghten it with? Is it just stretched or is something used to lengthen it. Thanks for your help.

Hey Cjaffee!
I am no doctor, but I think lateral column lengthening has to do with a tendon in your foot?!? Maybe lengthening a tendon will help your osteotomy go better and give better results. I would definately look up on the net any info. you can find on lateral column lengthening-maybe that would be of better help to you! Good luck with it all and let me know what you find out and what exactly it is! http://www.healthboards.com/ubb/smile.gif

Thanks. I did look it up and from what I could gather it's actually done with the bones versus the tendons. It sounds like they take a bone graft from the hip and place it on the heel. But I'm not quite sure why or exactly what that does. I'll continue to look and I'm due to talk to the doctor in 2 weeks so will find out more then. Either way it doesn't sound like fun.

Hello:

In July, 2001, I had a calcaneal osteotomy and lateral column lengthening which involved cutting the calcaneous in half and inserting a 12 mm bone graft from my hip into it. It failed, malunioned, and non unioned which left me in surgery again in August, 2002 with a titanium plate and 5 screws to hold the calcaneaus together. I now have calcaneal cuboid joint arthrosis so bad they are going back in to do one more fusion on 8/19/03. It has been a rough haul and I know some have had great success with this procedure. I also had chronic pain from flat feel all my life with two repaired posterior tib tendons which initiated the need for the osteotomy. I have no desire to do my right leg after so many months in casts, crutches and yet a third surgery pending. Good Luck. Paula

You're right a lateral column lengthening does involve a bone graft into the heel bone. Doing so allows the surgeon to recreate (or create) an arch. This is usually done with a tendon transfer for support. PLE, I am sooooooo sorry to hear about your bad experiences. I had this procedure done back in April, and so far everything seems to be healing well. CJaffee, you asked about my experiences in a different post. I was up on crutches the night of my surgery. I was in a cast for nine weeks, after which I went into a removeable "cam walker" boot. I was on crutches for 12 1/2 weeks (that was the most difficult part). I am about 15 weeks post-op right now. I had a small breakdown of the incision site which is finally healed. It's been a tough recovery, and it's not completely over yet. I pray that all goes well for you. I don't have any regrets, but I'm waiting until the final outcome to decide about the other foot. Anything else you'd like to know...feel free to ask!!

TPB - Can I ask what they used for hardware on your calcaneal osteotomy? Did they pin the fusion with a Steinmann pin, use a screw, a plate etc? They think mine went wrong because of a pin being used instead of something more secure like a screw? I spent almost a year in a cast and 6 total months on crutches with the first & second surgery and malunion/nonunion. I'm glad your went well, leaves me some optimism. Thanks Paula (PLE)

They used a k-wire (basically a pin) that was removed at the seven week point. Right now no hardware is in at all. Tomorrow will be exactly 15 weeks, the x-rays all look pretty good so far. My foot still swells quite a bit, and gets pretty sore at the end of the day. I'm still in a walking boot, for another month or so I'm told. I had a slight breakdown in one of the incisions, which is finally healed up, but held up my starting Physical therapy. Did your surgery sucessfully recreate your arch?? Going in, I was skeptical that my foot would respond...it was extremely flat, but it looks pretty good.

PLE, they used a k-wire (basically a pin), which was removed at the seven week point. It still gets pretty sore at the end of the day, and swells quite a bit. Did your surgery recreate your arch? I was skeptical at first, but it looks pretty good (when it's not swollen up, which masks the arch somewhat)

sorry about two answers...I didn't think the first one went through...

TPB, thank you very much for the information. After hearing about PLE I was getting a little skeptical but it sounds like each case is different. I travel for business and am probably most worried about the plane flights which start 3 weeks after surgery (I haven't check with the doc yet on that one - just hoping). I knew it would be 6 months before I was back to regular activity I'm just hoping it's not 12 - 18 like I've heard from some people.

Keep us informed on your continued progress. I look forward to following in your "foot steps" versus many of the others.

Hello:

As for my arch, well I think it has but to be honest because I still have so much pain and have yet one more fusion in a couple weeks, I do not know what effect the restructuring has really had for the good at this time. I am hopeful though that this next surgery to fuse and remove the plate while leaving one screw permanent will do the trick. Keep in touch and as mentioned by others, everyone is so different and I sure haven't had good success but Im hopeful in Montana.

I forgot to mention, that I flew six days after my surgery. It was about a 3 1/2 hr flight, and had absolutely no problem whatsoever. Some airlines do require that you have two slits cut into your cast (this is called "bi-valving) to allow for swelling, but honestly.. I had no problem at all!!

TPB,

Thanks for the news on travel. That's good news for me if it works out like that. Were you told that you have to worry about the incisions? I guess that's the worry the first few weeks. That swelling keeps the incision from healing?

TPB........Did they actually do the tendon transfer for support? I have a 7 yr. old that is having bilateral lateral column lengthenings on Sept. 3rd, and that little tid bit of info was interesting to us and we wondered if we should ask his doctor about it? How did it stabilize your feet or your walking, does it help to flatten out the feet?

[This message has been edited by ed2pooh (edited 08-31-2003).]

Hi Everyone! Sorry to jump in on this conversation a bit late - I just joined this board yesterday. Well, in 2000 (nearly 3 years ago, when I was 21 years old) I underwent a lateral column lengthening on both feet with tendon tightening and bone grafts, so I consider myself somewhat of an expert (!) The reason I underwent the proceedures was because I had bad pain related to flat foot deformity, and severe pronation. It was like my ankles were rolling right off my feet, and was not conducive to my very active lifestyle as a recent college grad at the time. No fun - but especially no fun when you are about to start your post-grad "life"! Anyway, it is defenitly a bone proceedure - they take the bone that rubs along near your pinky toe from heel to toe and they cut it in half, basically, inserting a wedge of bone grafted either from your hip or a bone bank. This swings your whole foot around, creating a slight arch. My doctor, who is VERY good (at the Cleveland Clinic) says this is the most powerful proceedure for flat foot deformity. WELL, my left foot went great, and my righht foot went well also, but the bone graft did not accept as well for my right foot. Because of this, the reconstruction was not as successful on my right foot and although I have a slight arch in my right foot, I was still feeling pain and I could tell from the way the soles of my shoes were wearing that I was still pronating on my right foot. I saw the doctor again recently, and 2 weeks ago I went in for a calcaneal osteotomy on my right foot with no plans to operate on my left, since it is now a wonderful foot with an arch and no pain (except for a bunion I plan to take care of within the next few years). I'm seriousd, my left foot turned out so well I can even wear high heels on that foot - no orthodic needed!!!!! It's great, let me tell you. Anyway, my Dr. said that the osteotomy I just had done will take care of the pain & pronation remaining on my right foot, and I hope he's right. There was no graft involved in my osteotomy, it sounds as though alot of folks on this board had osteotomies with grafts, but with my heel they just slid it 9 milimeters over.
I hope this info helps you a little! For anyone thinking about the lateral column lengthening, though, if you have a good Dr. DO IT!!!!!!! It changed my life. It gave me a life!!!
-Erin

Hi Again:

Well I am 2 wks out from the calcaneal cuboid joint fusion with bone from my knee, a 6.5" rod from heal forward for stabilization of the graft and 2 new 3.5 " screws all as follow up of my calcaneal osteotomy/lateral column lengthening and post op malunion and cuboid joint arthrosis. I hope this was the last one. I did fly home to Montana 4 days post op froom Seattle and did fine for those wanting to know about flying after surgery. Im on crutches for awhile again and since this is my 3rd surgery in 2 years, I'm a bit depressed over it, but trying to focus on the objective, not the obstacle as I read in a quote. http://www.healthboards.com/ubb/smile.gif

The rod may have to be removed someday but I'm hopeful this will have a happy ending as I'm only 33 years old. Thanks all and good luck on everyone who's gone through these procedures. Paula

Hi erinbenjamin,
I too, am thinking about the same surgery you had, but I don't know what type of surgeon to see: podiatric or orthopaedic. Could you share with me your surgeon's name and location. Also, how did you feel when you came out of surgery(pain level)?? How long were you in the hospital?? What did your recovery involve?? Thanks.
Hi Everyone! Sorry to jump in on this conversation a bit late - I just joined this board yesterday. Well, in 2000 (nearly 3 years ago, when I was 21 years old) I underwent a lateral column lengthening on both feet with tendon tightening and bone grafts, so I consider myself somewhat of an expert (!) The reason I underwent the proceedures was because I had bad pain related to flat foot deformity, and severe pronation. It was like my ankles were rolling right off my feet, and was not conducive to my very active lifestyle as a recent college grad at the time. No fun - but especially no fun when you are about to start your post-grad "life"! Anyway, it is defenitly a bone proceedure - they take the bone that rubs along near your pinky toe from heel to toe and they cut it in half, basically, inserting a wedge of bone grafted either from your hip or a bone bank. This swings your whole foot around, creating a slight arch. My doctor, who is VERY good (at the Cleveland Clinic) says this is the most powerful proceedure for flat foot deformity. WELL, my left foot went great, and my righht foot went well also, but the bone graft did not accept as well for my right foot. Because of this, the reconstruction was not as successful on my right foot and although I have a slight arch in my right foot, I was still feeling pain and I could tell from the way the soles of my shoes were wearing that I was still pronating on my right foot. I saw the doctor again recently, and 2 weeks ago I went in for a calcaneal osteotomy on my right foot with no plans to operate on my left, since it is now a wonderful foot with an arch and no pain (except for a bunion I plan to take care of within the next few years). I'm seriousd, my left foot turned out so well I can even wear high heels on that foot - no orthodic needed!!!!! It's great, let me tell you. Anyway, my Dr. said that the osteotomy I just had done will take care of the pain & pronation remaining on my right foot, and I hope he's right. There was no graft involved in my osteotomy, it sounds as though alot of folks on this board had osteotomies with grafts, but with my heel they just slid it 9 milimeters over.
I hope this info helps you a little! For anyone thinking about the lateral column lengthening, though, if you have a good Dr. DO IT!!!!!!! It changed my life. It gave me a life!!!
-Erin[/QUOTE]

Hi! I was in the hospital for each lateral column lengethening for 3 days. I would reccomend seeing an orthopaedic surgeon who specializes in foot & ankle surgery.
hope this helps,
Erin

Hi I just had the lateral column lengthening (along with the osteotomies) and was only in the hospital for 23 hours. It's too soon to see any results but after the first week at home things have been progressing quite nicely. Good luck.

CJaffee (ARE YOU STILL THERE?), :)

I've been checking out the old posts of your condition (flat feet...calcaneal osteotomy...).

I hope you receive this message and can respond on a few things to set my mind (and others) at ease with what you went through.

(1) What things did you have done with your surgery?
-was a Post Tib transfer involved with your calcaneal osteotomy?

(2) I believe it's been a year since your surgery?...
-Are you fully recovered and feeling no pain? Was it a success?

(3) Are you going to do the other foot as well?

(4) At what month(post op) do you feel you're back to normal walking and standing. CAN YOU JOG WITHOUT PAIN?

Would love to hear about your experiences.
Thanks,
Kyle