Opening-Wedge First Cuneiform Osteotomy (Usually with 2nd Through 4th Metatarsal Osteotomies) for Resistant Metatarsus Adductus Following Clubfoot Release
Resistant adduction of the forefoot is one of the more frequent residual deformities following surgical treatment of a congenital clubfoot. Residual forefoot adduction usually presents in patients older than 3 years of age and parents often feel it is a recurrence of the deformity, even though the examination and radiograph show good hindfoot correction. If untreated, the fitting and wearing of shoes may be difficult and an in-toeing gait is evident. Some children with this deformity develop a callus on the base of the 5th metatarsal, especially if there is an overactive anterior tibial tendon with adduction and supination of the forefoot. As the child grows, they may develop pain over the lateral foot with strenuous activity.
KeywordsWedge Osteotomy Congenital Clubfoot Metatarsal Osteotomy Metatarsal Angle Medial Cuneiform
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