The Results of Treatment of Planovalgus Deformity by Modified Grice-Green Procedure

Wang, Joon Ho; Lee, Seok Hyun; Lee, Young Koo

Abstract

PURPOSE: The author modified the technique of Grice-Green, for managing flexible flat foot, with severe hindfoot valgus and possible dorsiflexion more than 15 degrees. The purpose of this study was to evaluate the efficacy and results of this modified technique. MATERIAL AND METHODS: Total of 6 patients, 11 cases of pes planovalgus were operatively managed with Modified Grice-Green procedure from Nov. 1996 to April 2002. Total 11 cases in 6 patients were managed; 9 cases in 5 males, 2 cases in one female. The average age of the patients were 7.3 years (5.1-13.3 years). Average follow up period was 3.9 years (1.2-6.7 years). Patients were evaluated preoperatively and at last follow up radiologically and clinically. Radiologic evaluation were done by measuring the talocalcaneal and talo-1st metatarsal angles with the anteroposterior view; and by measuring the talo-1st metatarsal angles with the lateral view. The clinical outcome were rated by subjective and objective improvement level.
RESULTS
On follow up, 9 cases were complete satisfied, 2 cases were satisfied with minor reservation and no case had major reservations or dissatisfaction. Objective results were rated as excellent in 9 cases, good in 2 cases. Average preoperative talo-calcaneal and talo-1st metatarsal angles on anteroposterior radiograms were 34.4 degrees (16-40 degrees) and 32 degrees (8-48 degrees) respectively; which postoperatively on last follow up were 20 degrees (3-37 degrees) and 15.6 degrees (3-34 degrees) respectively. Average Preoperative talo-1st metatarsal angle on lateral radiogram was 18.4 degrees (6-30 degrees); which postoperatively on last follow up was 6.7 degrees (-6-17 degrees).
CONCLUSION
Modified Grice-Green operative procedure is effective and satisfactory procedure for planovalgus deformity in children. but for more accurate results, more patients and further follow up period are needed.