First Metatarsal Dorsal Close Wedge Osteotomy Combined with Medial Cuneiform Plantar Open Wedge Osteotomy for the Treatment of a Cavus Foot.
10.4055/jkoa.2010.45.1.24
- Author:
Jung Ryul KIM
1
;
Soo Kyung LEE
;
Hyung Seok LEE
Author Information
1. Department of Orthopaedic Surgery, Chonbuk National University Medical School, Research Institute of Clinical Science, JeonJu, Korea. jrkeem@chonbuk.ac.kr
- Publication Type:Original Article
- Keywords:
cavus;
forefoot deformity;
first metatarsal bone;
medial cuneiform;
dorsal wedge;
plantar open wedge;
osteotomy
- MeSH:
Animals;
Ankle;
Arthrodesis;
Congenital Abnormalities;
Follow-Up Studies;
Foot;
Heel;
Humans;
Maryland;
Metatarsal Bones;
Osteotomy;
Retrospective Studies
- From:The Journal of the Korean Orthopaedic Association
2010;45(1):24-30
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We wanted to analyze the results of the 1st metatarsal dorsal close wedge osteotomy (MTDW) combined with medical cuneiform plantar open wedge (MCPOW) for treating forefoot deformity of a cavus foot. MATERIALS AND METHODS: We retrospectively analyzed 30 patients. Their mean age was 21.5 years (SD 10.6 years) and the average follow-up period was 2.3 years. Thirty-four cases of thirty patients were classified as group A, as classified by the 1st MTDW combined with the MCPOW, 16 feet (14 patients) were group B by the 1st MTDW or MCPOW, 12 feet (10 patients), and group C by triple arthrodesis, 6 feet (6 patients). We evaluated the ankle dorsiflexion, plantarflexion, heel alignment, and the Maryland foot score (MFS) preoperatively and the last follow-up, and we analyzed the radiologic Hibb, Meary, calcaneal pitch and tibiotalar angles. RESULTS: The ankle dorsiflexion (p=0.01), plantar flexion (p=0.03) and heel alignment (p=0.02) of group A were significantly improved more than that of groups B and C. The MFS of group A revealed better than group B and C (p=0.01). The Meary (p=0.01), Hibb (p=0.02) and calcaneal pitch angle (p=0.02) of group A were significantly improved more than that of groups B and C. CONCLUSION: 1st MTDW combined with MCPOW osteotomy that focuses at the apex of the deformity for correction of a cavus foot can obtain better clinical and radiological results than other surgical procedures.
