Combined midfoot osteotomy for severe forefoot adductus

J. Eric Gordon, Scott J. Luhmann, Matthew B. Dobbs, Deborah A. Szymanski, Margaret M. Rich, David J. Anderson, Perry L. Schoenecker

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

A one-stage procedure combining a closing wedge osteotomy of the cuboid with an opening wedge of the medial cuneiform was used for the treatment of severe forefoot adductus. Results were reviewed in 33 patients (50 feet) followed-up for at least 2 years postoperatively. Clinical and radiographic improvement in forefoot position was achieved in 90% of cases. The mean calcaneo-second metatarsal angle improved from 37° preoperatively to 18° at final follow-up. The mean talo-first metatarsal angle improved from 15° preoperatively to 3° at final follow-up. The medial to lateral column ratio demonstrated 33% improvement after surgical treatment. Two feet were unimproved because of graft migration. Patients younger than age 5 years without a well-defined medial cuneiform ossific nucleus had a high rate of medial graft extrusion with loss of correction. This procedure should be reserved for patients aged 5 years or older. Ten patients followed-up for more than 6 years had no deterioration in results. This procedure provides effective, safe, predictable, and lasting correction of forefoot adductus.

Original languageEnglish
Pages (from-to)74-78
Number of pages5
JournalJournal of Pediatric Orthopaedics
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2003

Keywords

  • Cuboid osteotomy
  • Cuneiform osteotomy
  • Metatarsus adductus
  • Skewfoot

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