Evaluation of the Efficiency of Double Osteotomy Technique for Residual Metatarsus Adductus Deformity

Abstract

Aim:The most common congenital foot deformity in the neonatal period is metatarsus adductus. The aim of the treatment is to correct the supination of the tarsometatarsal joints and to provide the correct metatarsal alignment. In this study, the clinical and radiological effectiveness of open wedge medial cuneiform and closing wedge cuboid osteotomies in the surgical treatment of metatarsus adductus is investigated.Materials and Methods:Twenty-five feet of 17 patients (13 males and 4 females), who had metatarsus adductus deformity and were operated with the combination of open wedge medial cuneiform and closing wedge cuboid osteotomies, were evaluated retrospectively. The etiological factors of the deformities were noted. In the radiological assessment, talus-1st metatarsal and calcaneus-5th metatarsal angles in the AP standing radiographs as well as talus-1st metatarsal angle in the standing lateral radiographs were measured on pre and postoperative periods in all cases. The radiological alterations were evaluated in terms of statistical significance.Results:Metatarsus adductus deformity was due to pes equinovarus sequelae in 12 of 17 cases. In rest of the cases, the etiological factors were congenital, cerebral palsy sequelae, spina bifida, vertical talus and Charcot-Marie-Tooth disease. All measured radiographical angles were found to be improved in the postoperative period when compared with the preoperative values.Conclusion:Combination of open wedge medial cuneiform and closing wedge cuboid osteotomies in the surgical treatment of metatarsus adductus deformities gives satisfactory clinical and radiological outcomes. The technique is effective in correcting forefoot adduction and midfoot supination with low complication rates.

Keywords

• cuboid
• cuneiform
• metatarsus adductus
• osteotomy