Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children

Mahadev, A.; Munajat, I.; Mansor, A.; Hui, J.H.P. (2009) Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children. Clinical Orthopaedics and Related Research, 467 (5). pp. 1319-1325. ISSN 0009-921X

[img] PDF - Published Version
Restricted to Registered users only [error in script]

Download (246Kb) | Request a copy

    Abstract

    Residual deformity in resistant clubfoot is not uncommon. The "bean-shaped foot" exhibits forefoot adduction and midfoot supination and may interfere with function due to poor foot placement. For children less than 5 years of age we describe a corrective procedure combining a closing wedge cuboidal osteotomy and trans-midfoot rotation procedure without a medial opening wedge osteotomy. We retrospectively reviewed twelve patients (14 feet), mean age 4.7 years (range, 4-5 years), who had undergone the procedure to correct forefoot adduction and midfoot supination deformities. We obtained minimal access via a small lateral skin incision. Cuboid lateral wedge osteotomy was followed by transcuneiform osteotomy using a Kirschner wire as a guide under an image intensifier. The minimum followup was 2 years (mean, 2.6 years; range, 2�3.2 years). All patients had qualitative improvement in correction of adduction and supination deformities. Radiographically there was an improvement in adduction deformity, the mean anteroposterior talo-first metatarsal and calcaneo-fifth metatarsal angles improved by 28° (from 40° to 12°) and by 11° (from 21° to 10°). The supination improved by 11° (from 19° to 8°) and the cavus improved by 17° (from 30° to 13°). The short-term outcome was reliable and this combination is useful for children younger than 5 years old where the medial cuneiform ossification center remained poorly defined.

    Item Type: Article
    Creators:
    1. Mahadev, A.
    2. Munajat, I.
    3. Mansor, A.(Department of Orthopaedic Surgery, Faculty of Medicine Building, University of Malaya, 50603 Kuala Lumpur, MALAYSIA)
    4. Hui, J.H.P.
    Journal or Publication Title: Clinical Orthopaedics and Related Research
    Additional Information: Department of Orthopaedic Surgery, Faculty of Medicine Building, University of Malaya, 50603 Kuala Lumpur, MALAYSIA
    Uncontrolled Keywords: Orthopaedic Surgery
    Subjects: R Medicine
    Divisions: Faculty of Medicine
    Depositing User: Ms Haslinda Lahuddin
    Date Deposited: 19 Jun 2012 10:47
    Last Modified: 19 Jun 2012 10:47
    URI: http://eprints.um.edu.my/id/eprint/3328

    Actions (For repository staff only: Login required)

    View Item

    Document Downloads

    More statistics for this item...