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KMID : 1130920100140020130
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Journal of Korean Foot and Ankle Society
2010 Volume.14 No. 2 p.130 ~ p.134
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Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot
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Chu In-Tak
Park Jong-Min
Yoo Jong-Min
Chung Jin-Wha
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Abstract
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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 21° and 25° to 12° and 19°, respectively, at last followup. Also, calcaneus-1st metatarsal angle was increased from the mean 114° to 144°. 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.
Conslusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
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KEYWORD
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Foot, Cavovarus, Calcaenal osteotomy, First metatarsal osteotomy, Plantar fascia release
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