Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지

Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot

내반 요족 변형에서 시행한 제1중족골 및 종골에 대한 절골술

  • Chu, In-Tak (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University) ;
  • Park, Jong-Min (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University) ;
  • Yoo, Jong-Min (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University) ;
  • Chung, Jin-Wha (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University)
  • 주인탁 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 박종민 (가톨릭대학교 의과대학 여의도성모병원 정형외과) ;
  • 유종민 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 정진화 (가톨릭대학교 의과대학 여의도성모병원 정형외과)
  • Received : 2010.10.18
  • Accepted : 2010.11.18
  • Published : 2010.12.15
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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 $1^{st}$ 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-$1^{st}$ metatarsal, calcaneus-$1^{st}$ metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-$1^{st}$ metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of $21^{\circ}$ and $25^{\circ}$ to $12^{\circ}$ and $19^{\circ}$, respectively, at last followup. Also, calcaneus-$1^{st}$ metatarsal angle was increased from the mean $114^{\circ}$ to $114^{\circ}$. 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.

Keywords

References

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