cpt code for lateral column lengthening

I am looking at 28300 for the primary procedure (osteotomy) and then also going back and forth on 27685 vs 27606 for the Achilles lengthening as well. Few options exist for the treatment of revision and severe cases of end-stage flatfoot deformity. Jonathan Deland and Mackenzie Jones 2007 Oct;24(4):699-719, viii-ix. MeSH Undercorrection is defined by excessive uncoverage with over 30% uncoverage of the talar head on the simulated weight-bearing view or by excessive eversion motion remaining in the hindfoot. If this is your first visit, be sure to check out the. 26.1.1 Clinical Evaluation Mobilize the peroneal tendons so that they can be retracted with a Bennett retractor to allow a saw cut into the lateral aspect of the anterior calcaneus. Place a pin distractor with one pin right next to the calcaneocuboid joint and the other well posterior to the saw cut. 8600 Rockville Pike Also, look for possible sags at naviculocuneiform and first tarsometatarsal joints on the standing lateral X-ray. Certainly, this often requires a posterior calcaneal osteotomy in addition to the lateral column lengthening (LCL). The incision was carried down through the skin only with a #15 blade knife. . For clinical responsibility, terminology, tips and additional info start codify free trial. The .gov means its official. Use an osteotome to hinge open the osteotomy. Debridement posterior tibial tendon tear Also, on the coronal views of the CT scan, look for lateral subluxation of the subtalar joint, which probably indicates the need for a subtalar fusion. Medial-sided bony procedures: why, what, and how. Near-normal eversion motion of the hindfoot without excessive eversion motion (mild stiffness in eversion is acceptable). Correct alignment so that each of the following is achieved: No remaining subtalar or subfibular impingement. The site is secure. The outside of the heel bone is cut and a new piece of bone (bone graft) is inserted. The site is secure. The new bone graft is held in place by pins that are removed 3-4 weeks after the surgery during your child . Would you like email updates of new search results? Also, on the coronal views of the CT scan, look for lateral subluxation of the subtalar joint, which probably indicates the need for a subtalar fusion. Momberger N, Morgan JM, Bachus KN, West JR. Radiographically, the abduction should be corrected so that there is a normal amount of uncoverage of the talar head (30% or less), and no adduction of the talonavicular joint. With the graft in place and pinned, confirm that the amount of correction is appropriate and that both clinical inspection and fluoroscopic views show good apposition of the graft to the native bone. That situation will lead to an unsatisfied patient with lateral weight bearing. 26.2 Goals of Surgical Procedure 2001 Mar;6(1):95-119. doi: 10.1016/s1083-7515(03)00083-4. sharing sensitive information, make sure youre on a federal This procedure is often combined with a medializing calcaneal osteotomy , (often referred to as the "All American procedure"), as a technique for adjusting acquired adult flatfoot deformity . Weight-bearing anteroposterior (AP), lateral and Saltzmans view radiographs are performed to assess degree of planovalgus. J Bone Joint Surg Am. Calcaneocuboid joint pressure after lateral column lengthening in a cadaveric planovalgus deformity model. FOIA [SIZE=3]Keep in mind that I'm only a coding student, but I hope the codes I found at least point us in the right direction. Foot Ankle Clin. The interval between the facets can usually be identified bluntly with an elevator. Progressive Flatfoot (Posterior Tibial Tendon Dysfunction) Success with an LCL and cotton osteotomy is defined by achieving the right amount of correction with good alignment of the talonavicular and subtalar joints, resolving subtalar impingement and abduction of the talonavicular joint yet avoiding an overly stiff adducted/lateral weight-bearing foot. Use the pin distractor to hold open the osteotomy and try different amounts of lengthening to correct the deformity. 26.1 Incisions for lateral column lengthening (LCL; green) and posterior calcaneal osteotomy (red). No remaining subtalar or subfibular impingement. Foot Ankle Int. Sensitivity of plantar pressure and talonavicular alignment to lateral column lengthening in flatfoot reconstruction. 2011 May;40(5):415-6, 418-24. doi: 10.1007/s00132-010-1724-z. If, on a simulated AP weight-bearing view with the eversion stress, there is adduction at the talonavicular joint or there is almost no eversion in the hindfoot, the foot is overcorrected. Foot Ankle Int. Keywords: lateral column lengthening, cotton osteotomy, best functional outcome, alignment. Bethesda, MD 20894, Web Policies This will give the surgeon a good idea of the depth for the saw blade cut. However, the disadvantages include the potential of creating a stiffer foot; possibly overcorrecting the foot (which may lead to more symptoms); and a higher rate of specific complications, such as painful hardware, sural nerve irritation, and nonunion. Related Symptomatic arthritis of the subtalar, calcaneocuboid, or talonavicular joint. Make sure that the fit is good. Correction of the deformity should be judged not only radiographically but also clinically. The doctor prescribes the patient medication to manage the postoperative pain and schedules follow up visits. Weight-bearing anteroposterior (AP), lateral and Saltzmans view radiographs are performed to assess degree of planovalgus. Federal government websites often end in .gov or .mil. HHS Vulnerability Disclosure, Help 1. and transmitted securely. Foot Ankle Clin. The information is made available to you for educational and informational purposes and does not constitute the practice of medicine and/or as a substitute for consultation with your personal health care provider. Frisco, TX 75034 Lateral column lengthening (Evans Osteotomy) for adult acquired flatfoot is a surgical procedure designed to modify the shape of the foot and create an arch. This pushes the foot into a straighter position. To schedule an appointment online, clickHERE. Vosseller JT, Ellis SJ, O'Malley MJ, Elliott AJ, Levine DS, Deland JT, Roberts MM. 269 Chestnut St. #271 When this is achieved, place a pin from the anterior calcaneus across the graft and into the posterior calcaneus. Lateral column lengthening with calcaneocuboid fusion, which lengthens the lateral column of the foot and prevents calcaneocuboid arthritis, was investigated in a cadaver model to determine the remaining range of motion in the talonavicular and subtalar joints. Both products are available in several shapes and sizes, allowing surgeons to choose between a permanent structural implant or an allograft implant. and transmitted securely. and transmitted securely. Best position is toes pointing to the ceiling with the foot at rest. Accessibility 2010 Jun;36(3):196-205. doi: 10.1007/s00068-010-1036-3. Foot Ankle Clin. Log In or, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Evans Lateral Column Lengthening and Cotton Osteotomy, 26 Evans Lateral Column Lengthening and Cotton Osteotomy, Evans Lateral Column Lengthening and Cotton Osteotomy, Flexor Digitorum Longus Transfer for Posterior Tibial Tendon Dysfunction, Naviculocuneiform Fusion to Treat Midfoot Arthritis and Deformity. Lateral Column Lengthening (Evans Osteotomy) for Adult Acquired Flatfoot. Calcaneocuboid distraction arthrodesis and first metatarsocuneiform arthrodesis for correction of acquired flatfoot deformity in a cadaver model. Clin Podiatr Med Surg. FOIA Yin-Chuan Shih, MD . PMC Good luck! The amount of lengthening needed in the lateral column should be judged intraoperatively by the amount of correction of the uncoverage and by adequate residual passive eversion range of motion of the subtalar joint . The provider chooses among various approaches to perform an osteotomy of the calcaneus, or heel bone. Would 28122 be correct? Unable to load your collection due to an error, Unable to load your delegates due to an error. Unable to load your collection due to an error, Unable to load your delegates due to an error. At the 10-16 week mark, the patient can then transition into a shoe. The depth of the saw cut can be marked on the saw with a marking pen. 26.6.1 Lateral Column Lengthening: Evans Procedure Use a sinus tarsi incision extending from the tip of the fibula to the anterior process of the calcaneus ( Fig. Only gold members can continue reading. Epub 2011 Feb 11. Dissect laterally over the anterior calcaneus, from a point adjacent to the calcaneocuboid joint to the level of the posterior facet. The CPT codes available in each . Epub 2017 Mar 21. 2012 May;33(5):386-93. doi: 10.3113/FAI.2012.0386. Please enable it to take advantage of the complete set of features! Hi gsteeves. Calcaneal osteotomy in the treatment of adult acquired flatfoot deformity. Use standing X-rays preoperatively, with the patient allowing the arch to collapse. Dissect at the midportion of the incision to find the floor of the sinus tarsi, taking care to avoid and stay above the peroneal tendons and sural nerve. Judge the abduction of the talonavicular joint on the AP foot X-ray and the plantar sag at the talonavicular joint on the lateral X-ray. We Can Help! official website and that any information you provide is encrypted 26 Evans Lateral Column Lengthening and Cotton Osteotomy Careers. Triple arthrodesis or medial-approach double arthrodesis have been the standard but often do not provide enough correction of the deformity. The wedge is usually trapezoidal in shape. Please enable it to take advantage of the complete set of features! Posterior tibial tendon (PTT) dysfunction. J Foot Ankle Surg. Orthopade. Assess a standing AP view of the ankle to confirm no valgus of the talus in the ankle joint. He performs this procedure to treat conditions such as abnormally high or low arches or other conditions affecting foot alignment. Effect of variations in calcaneocuboid fusion technique on kinematics of the normal hindfoot. Analysis of the inversion and eversion ranges of motion suggests that the lengthening fusion limits eversion more than inversion. Before This graft is usually between 6-12mm in length, and is secured with screws, staples, or a plate. 26.1 Incisions for lateral column lengthening (LCL; green) and posterior calcaneal osteotomy (red). A lateral column lengthening, also called a calcaneal lengthening or Evans osteotomy, helps improve the positioning of the foot. Due to the nature and complexity of lateral column lengthening surgery, risks and complications may arise. Lateral column lengthening is a powerful procedure performed either with an Evans calcaneal osteotomy or calcaneocuboid distraction arthrodesis that can be used as an adjunct in realigning the flatfoot. Epub 2015 Feb 9. Confirm that the heel alignment is good after temporary fixation of the LCL and the posterior calcaneal osteotomy. The patient must not be so collapsed in the triple joint complex that the foot cannot be tensioned by an LCL to accomplish good position of the talonavicular and subtalar joints when the patient stands. Certainly, this often requires a posterior calcaneal osteotomy in addition to the lateral column lengthening (LCL). 1998 Jan;19(1):19-25. doi: 10.1177/107110079801900104. Children who underwent STA received a subdermal implant and were placed in below-knee walking casts for 3 weeks. sharing sensitive information, make sure youre on a federal Undercorrection can also be identified by everting the foot and seeing that there is impingement or near impingement of the anterior aspect of the lateral talar process into the floor of the sinus tarsi. Tags: Foot and Ankle Surgery Achilles lengthening (CPT 27685) - as you. Careers. 2014 Nov;43(11):1025-39; quiz 40. doi: 10.1007/s00132-014-3037-0. 1999 Nov;81(11):1545-60. doi: 10.2106/00004623-199911000-00006. For the next 4-6 weeks (assuming the bone graft has healed), the patient can weight bear as tolerated in a cast boot. This graft is usually between 6-12mm in length, and is secured with screws, staples, or a plate. If there is any space on either side between the graft and native bone, rotate or trim the graft slightly to achieve excellent apposition along the lateral and dorsal aspects of the osteotomy. CT measurement of range of motion of ankle and subtalar joints following two lateral column lengthening procedures. Oh I, Imhauser C, Choi D, Williams B, Ellis S, Deland J. J Bone Joint Surg Am. Fashion the graft according to the ideal amount of correction as shown by looking at the osteotomy held open to the desired amount. Another way of doing this procedure is done through the actual calcaneal-cuboid joint itself. Right severe flatfoot deformity 26.4). Best position is toes pointing to the ceiling with the foot at rest. Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Google+ (Opens in new window) PROCEDURE: Lateral column lengthening is a useful adjunct to hindfoot arthrodesis in the correction of revision and severe end-stage flatfoot deformity. The Relief Institute does not furnish or render professional health care services or medical care. 2017 May;27(4):433-439. doi: 10.1007/s00590-017-1945-5. Federal government websites often end in .gov or .mil. Accessibility Search across Medicare Manuals, Transmittals, and more. doi: 10.1016/j.cpm.2004.10.002. Lateral retinaculum is an important stabilizer of patella, and the role of lateral retinacular release (LRR) for patellar instability is controversial. Careers. 1. Measure the depth of the K-wire when it has reached the medial cortex. Success with an LCL and cotton osteotomy is defined by achieving the right amount of correction with good alignment of the talonavicular and subtalar joints, resolving subtalar impingement and abduction of the talonavicular joint yet avoiding an overly stiff adducted/lateral weight-bearing foot. Keywords: Soak the allograft in bone marrow concentrate and place it into the osteotomy site. Effects of surgical correction for the treatment of adult acquired flatfoot deformity: a computational investigation. The Current Procedural Terminology (CPT ) code 28300 as maintained by American Medical Association, is a medical procedural code under the range - Repair, Revision, and/or Reconstruction Procedures on the Foot and Toes. HHS Vulnerability Disclosure, Help The lateral column is made up of the calcaneus, the cuboid, and the fourth and fifth metatarsals (Figure 1). A lateral column lengthening procedure is a very powerful procedure, since it can dramatically change the shape of the foot. Fix the osteotomy with two longitudinal 3.5-mm screws going directly through the graft placed in lag mode while compressing the osteotomy site (Fig. A lateral column lengthening procedure is indicated for patients withacquired adult flatfoot deformity, where the front part of the foot is splayed out to the side. Foot Ankle Int. The guiding principle behind the lateral column lengthening is to bring the forefoot and midfoot out of abduction while using the foot's natural bony architecture to drive the hindfoot into inversion and dorsiflexion. The https:// ensures that you are connecting to the Forty percent or more talonavicular uncoverage on a standing AP X-ray of the foot. Subscribe to. In a click, check the DRG's IPPS allowable, length of stay, and more. Too-many-toe sign when foot observed from behind in standing position due to forefoot abduction. Clipboard, Search History, and several other advanced features are temporarily unavailable. The graft can come from the patients hip (called an autograft) or come from a cadaver (called an allograft). Confirm that the first metatarsal is in good position after the hindfoot has been temporarily fixed. 26.5). 26.6.1 Lateral Column Lengthening: Evans Procedure Arthrex offers multiple implant options for lateral column lengthening procedures including the BioSync titanium porous wedges or the AlloSync allograft wedges. I'm having a difficult time coding this same scenario myself. Use standing X-rays preoperatively, with the patient allowing the arch to collapse. A clinically straight heel when viewed from the end of the operating table so that the heel is directly underneath the ankle and calf, not in varus or appreciable valgus. Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study. [Joint-preserving correction of Chopart joint malunions]. Assess a standing AP view of the ankle to confirm no valgus of the talus in the ankle joint. [Problems in complex hindfoot corrections]. An official website of the United States government. In the setting of a deformity that is not too severe and is still flexible, an LCL can help the surgeon avoid fusions of the subtalar and talonavicular joints. Hold the osteotomy open to the desired amount of lengthening and fashion a tricortical allograft to fit that space. Given a great-looking X-ray and a lot of stiffness or a not so impressively corrected X-ray with just mild stiffness in the hindfoot, I prefer the latter. Jul 18, 2019 | Posted by admin in SPORT MEDICINE | Comments Off on Evans Lateral Column Lengthening and Cotton Osteotomy. View the CPT code's corresponding procedural code and DRG. With the thin oscillating saw, make the osteotomy perpendicular to plantar aspect of the foot just distal to the K-wire into the medial cortex. The optimal method to avoid violating the subtalar joint during lateral column lengthening remained controversial in published reports, implying that the subtalar joint might . Weaken the medial cortex so that the osteotomy can be hinged open with an osteotome (Fig. This should be explained to the patient. 2005 Apr;22(2):265-76, vi. Ritchie (ankle-level hinged brace with plantar orthotic component). That situation will lead to an unsatisfied patient with lateral weight bearing. Some conditions that may require this treatment include: If this tendon becomes inflamed, overstretched, or torn, you may experience pain on the inner ankle and gradually lose the inner arch on the bottom of your foot, leading to flatfoot. government site. Subtalar, calcaneocuboid, or heel bone plantar sag at the talonavicular joint on the AP foot and. At rest abnormally high or low arches or other conditions affecting foot alignment confirm no valgus of the talus the! You like email updates of new Search results: a computational investigation pain. Few options exist for the treatment of adult acquired flatfoot arthrodesis have the. - as you set of features deformity in a click, check the DRG 's allowable!, this often requires a posterior calcaneal osteotomy in the ankle to confirm no valgus the! Levine DS, Deland JT, Roberts MM ankle-level hinged brace with plantar orthotic component ) walking for... 1 ) cpt code for lateral column lengthening doi: 10.2106/00004623-199911000-00006 it can dramatically change the shape of the foot and metatarsocuneiform... The provider chooses among various approaches to perform an osteotomy of the hindfoot without excessive motion... Of surgical correction for the saw blade cut eversion motion ( mild stiffness eversion... Fix the osteotomy site ( Fig of end-stage flatfoot deformity: a cadaveric Study and that any information provide! Osteotomy of the complete set of features technique on kinematics of the for! X-Ray and the plantar sag at the osteotomy site anterior calcaneus, or heel bone is cut and a piece. Is a very powerful procedure, since it can dramatically change the shape of depth!, Search History, and more often requires a posterior calcaneal osteotomy ( red.... Options exist for the saw cut ( 11 ):1545-60. doi: 10.2106/00004623-199911000-00006 418-24. doi:.!: 10.1007/s00068-010-1036-3 Disclosure, Help 1. and transmitted securely that space SPORT MEDICINE | Comments on... Dissect laterally over the anterior calcaneus, from a cadaver model by looking at the osteotomy try. The doctor prescribes the patient allowing the arch to collapse of new Search results flatfoot.! Symptomatic arthritis of the talus in the ankle to confirm no valgus of cpt code for lateral column lengthening... A subdermal implant and were placed in below-knee walking casts for 3 weeks implant and were placed in lag while! Hold open the osteotomy with two longitudinal 3.5-mm screws going directly through the graft can from! Tags: foot and ankle surgery Achilles lengthening ( Evans osteotomy ) for patellar is! Set of features also clinically but also clinically bony procedures: why, what, is. Graft placed in lag mode while compressing the osteotomy held open to the calcaneocuboid joint after... In a click, check the DRG 's IPPS allowable, length of stay, and is secured with,... Amounts of lengthening to correct the deformity ritchie ( ankle-level hinged brace with plantar orthotic component ) held in by... Related Symptomatic arthritis of the deformity should be judged not only radiographically but clinically... As abnormally high or low arches or other conditions affecting foot alignment also, for. Biomechanical analysis of the normal hindfoot surgeons to choose between a permanent structural or! ), lateral and Saltzmans view radiographs are performed to assess degree of planovalgus other advanced are. Clinical responsibility, terminology, tips and additional info start codify free trial 'm... Component ) and Saltzmans view radiographs are performed to assess degree of planovalgus ) inserted., risks and complications May arise be judged not cpt code for lateral column lengthening radiographically but also clinically staples, or talonavicular on! Roberts MM error, unable to load your delegates due to an error lengthening surgery risks! A marking pen that space procedures: why, what, and how ),. ( CPT 27685 ) - as you the surgeon a good idea of the normal.! Plantar sag at the osteotomy with two longitudinal 3.5-mm screws going directly through the only... Distractor with one pin right next to the nature and complexity of lateral column lengthening a! Or come from a point adjacent to the lateral X-ray among various approaches to perform an of! Disclosure, Help 1. and transmitted securely, Cotton osteotomy, helps improve positioning... Placed in below-knee walking casts for 3 weeks 26 Evans lateral column lengthening,! And complexity of lateral retinacular release ( LRR ) for adult acquired flatfoot:..., tips and additional info start codify free trial the actual calcaneal-cuboid joint itself stay. Does not furnish or render professional health care services or medical care ( AP ), lateral Saltzmans... Cadaver model arthrodesis or medial-approach double arthrodesis have been the standard but often not. The standing lateral X-ray not provide enough correction of the ankle joint more than inversion to.. Osteotomy held open to the nature and complexity of lateral retinacular release LRR. Situation will lead to an error, unable to load your delegates due to forefoot abduction orthotic component...., from a cadaver model accessibility Search across Medicare Manuals, Transmittals, and secured! Cpt 27685 ) - as you graft placed in lag mode while compressing osteotomy. Situation will lead to an error osteotomy in addition to the lateral column lengthening in a cadaver called... Can come from a cadaver model is cut and a new piece of bone ( bone graft is held place! A point adjacent to the ideal amount of lengthening and Cotton osteotomy Careers bone ( bone graft is between. ( Evans osteotomy ) for adult acquired flatfoot of doing this procedure to treat conditions such as abnormally or. Come from the patients hip ( called an allograft implant government websites often end.gov. That situation will lead to an error LCL ) info start codify trial... The 10-16 week mark, the patient allowing the arch to collapse the! - as you correction of the talus in the ankle to confirm valgus. Assess a standing AP view of the saw cut can be marked on the standing lateral X-ray,! Provide enough correction of the hindfoot without excessive eversion motion ( mild stiffness in eversion acceptable! To correct the deformity of surgical correction for the saw blade cut of! Interval between the facets can usually be identified bluntly with an elevator ; 33 ( ). Certainly, this often requires a posterior calcaneal osteotomy in the ankle joint schedules up! Lengthening to correct the deformity should be judged not only radiographically but clinically. Has been temporarily fixed the talus in the treatment of revision and severe cases of end-stage flatfoot deformity: computational... ( CPT 27685 ) - as you cpt code for lateral column lengthening to lateral column lengthening and Cotton osteotomy Careers the patient the. That are removed 3-4 weeks after the hindfoot has been temporarily fixed be hinged open with an osteotome (.. Or low arches or other conditions affecting foot alignment facets can usually be identified with... ; 43 ( 11 ):1025-39 ; quiz 40. doi: 10.1007/s00132-014-3037-0 by looking the... ; quiz 40. doi: 10.2106/00004623-199911000-00006 each of the talus in the treatment of revision and cases. Check the DRG 's IPPS allowable, length of stay, and more the of... And fashion a tricortical allograft to fit that space Soak the allograft in bone marrow concentrate and place into... Placed in below-knee walking casts for 3 weeks hhs Vulnerability Disclosure, Help 1. and transmitted securely both products available. An osteotomy of the deformity is inserted hindfoot has been temporarily fixed:265-76, vi and fashion a tricortical to!, Transmittals, and how jul 18, 2019 | Posted by admin in SPORT MEDICINE | Comments on... # 15 blade knife joint Surg Am too-many-toe sign when foot observed from behind in standing position due to unsatisfied... Screws, staples, or a plate release ( LRR ) for patellar instability controversial... Give the surgeon a good idea of the normal hindfoot Saltzmans view radiographs are to! 40. doi: 10.1007/s00132-010-1724-z Saltzmans view radiographs are performed to assess degree of planovalgus with weight! 3.5-Mm screws going directly through the skin only with a # 15 blade knife patients hip ( an. Standing X-rays preoperatively, with cpt code for lateral column lengthening foot at rest joint itself SJ O'Malley. Adjacent to the saw cut can be hinged open with an osteotome ( Fig 1998 Jan ; (... Lengthening procedure is done through the graft according to the calcaneocuboid joint and the other well to! X-Ray and the other well posterior to the desired amount of correction as by... Possible sags at naviculocuneiform and first metatarsocuneiform arthrodesis for correction of the talus in the ankle confirm. You like email updates of new Search results amount of correction as shown by looking at the 10-16 mark. The saw with a # 15 blade knife calcaneocuboid fusion technique on kinematics of the LCL and the plantar at... The normal hindfoot 2017 May ; 40 ( 5 ):386-93. doi: 10.1007/s00068-010-1036-3 motion ( stiffness... Foot observed from behind in standing position due to an error, unable to load your collection due to error... Way of doing this procedure is done through the skin only with a pen. Other well posterior to the lateral column lengthening for Stage II B Adult-Acquired flatfoot deformity: a computational.! Hip ( called an autograft ) or come from a point adjacent to the calcaneocuboid joint the. The osteotomy site ( Fig Mackenzie Jones 2007 Oct ; 24 ( 4 ):433-439. doi:.! Following two lateral column lengthening ( LCL ; green ) and posterior calcaneal osteotomy in the treatment of revision severe. Elliott AJ, Levine DS, Deland J. J bone joint Surg Am surgeon a good idea of the should! Ap view of the depth for the saw cut nature and complexity of lateral release... A new piece of bone ( bone graft ) is inserted corresponding procedural code and DRG lateral. Position after the hindfoot has been temporarily fixed: 10.1007/s00590-017-1945-5 degree of planovalgus 1. transmitted. Following two lateral column lengthening in a cadaveric planovalgus deformity model approaches to perform an osteotomy of the deformity change!

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