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

Mahadev, A. and Munajat, I. and Mansor, A. and 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, DOI

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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
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 02:47
Last Modified: 19 Jun 2012 02:47

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