Patient outcomes following flat foot reconstruction with the use of a spring ligament fiber tape device. A little bit of background on our project, flat foot deformities are chronic debilitations. They involve multiple ligament complexes that stabilize the hind foot. And to date, no study has clearly evaluated the efficacy of utilizing the spring ligament internal brace fiber tape device as an adjunct through clinical and radiographic measures. The purpose of our study was to explore the diagnostic efficacy of 3T MRIs to evaluate the spring ligaments and to compare operative failures, complications, and radiographic outcomes of patients who underwent procedures for posterior tibial tendon dysfunction, PTTD, that employed the internal brace fiber tape, the IB group, and those that did not in the non-internal brace, the NIB group. Our methods involved first gaining IRB approval and then patients that underwent flat foot reconstruction by four surgeons at a single institution between 2015 and 2018 were queried from an institutional radiology database. A total of 44 cases were identified with procedures that utilize the IB and those that underwent MRI preoperatively had spring ligament integrity compared to intraoperative findings. These 44 cases that utilize the IB were subsequently match paired in a one to two ratio with an NIB group. Data was collected retrospectively for both clinical and radiographic outcomes. Clinical outcomes included failures leading to reoperation, complications, and additional procedures. Radiographic parameters involved pre and post-operative comparisons. Intraadvertent reoperations that implicated malunion or the need for a triple atherodesis within 13 months of the initial procedure were compared and patient complications were also compared. Statistical analysis was performed to evaluate the relationship between the clinical outcomes of these patients and use of the IB as an additional source of stabilization. A total of 132 cases were analyzed with 44 that employed the IB and 88 that employed the NIB. The average ages for each group were 46.7 years for the IB group and 46.5 years for the NIB group. This showed that age was not a confounding variable between the two groups. Of the 44 IB patients, zero out of the 10, that's 0% who had received a preoperative MRI were correctly identified as having an attenuated or frankly torn spring ligament as determined intraoperatively. This showed that the MRI was ineffective in determining whether or not a patient presented with a spring ligament tear. There were significant differences in failure rates between groups with 0% of IB procedures resulting in failure and 4.5% of NIB procedures resulting in failure. That's a P of 0.022. There were no significant differences among complications between groups. Results demonstrate that the spring ligament internal brace device may serve as an effective adjunct in PTD procedures. And we suggest considering it when planning spring ligament repairs, irrespective of preoperative MRI findings. Again, this is because the MRI was shown to be ineffective in determining whether or not a patient presented with a spring ligament tear. The data suggests that failure rates may be reduced without increasing complications as well. Both methods of fixation can provide significant improvements in reconstructing the arc. However, the internal brace may reduce the prevalence of postoperative recurrent deformity or the need for a triple atherodesis. Thank you.

spring ligament fiber tape devices

flat foot reconstruction

3T MRIs

spring ligament internal brace fiber tape

posterior tibial tendon dysfunction procedures