J Korean Foot Ankle Soc.
2010 Dec;14(2):130-134.
Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot
- Affiliations
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- 1Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic Universtiy of Korea, Seoul, Korea. koreafoot@gmail.com
- 2Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic Universtiy of Korea, Seoul, Korea.
Abstract
- PURPOSE
The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot.
MATERIALS AND METHODS
We performed a dorsal closing wedge 1st metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-1st metatarsal, calcaneus-1st metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection.
RESULTS
Talo-1st metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of 21degrees and 25degrees to 12degrees and 19degrees, respectively, at last followup. Also, calcaneus-1st metatarsal angle was increased from the mean 114degrees to 144degrees. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes.
CONCLUSION
Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
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