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.
KeywordsAdduct Crest Dial Serpentine Shoe
Unable to display preview. Download preview PDF.
- 2.Berman, A., Gartland, J.J.: Metatarsal osteotomy for the correction of adduction of the fore part of the foot in children. J. Bone Joint Surg., 53-A:498–506, 1971.Google Scholar
- 3.Coleman, S.S.: Complex foot deformities in children. Philadelphia: Lea & Febiger, 1983;94–98Google Scholar
- 4.Fowler, S.B., Brooks, A.L., Parrish, T.F.: The cavovarus foot. J. Bone Joint Surg., 41-A:757, 1959.Google Scholar
- 5.Heyman, C.H., Strong, J.M.: Mobilization of the tarso-metatarsal and intermetatarsal joints for the correction of resistant adduction of the forepart of the foot in congenital clubfoot or congenital metatarsus varus. J. Bone Joint Surg., 44-A:299–309, 1958.Google Scholar
- 6.Hoffman, A.A., Constine, R.M., McBride, G.G., Coleman, S.S.: Osteotomy of the first cuneiform as treatment of residual adduction of the fore part of the foot in club foot. J. Bone Joint Surg., 66-A:985–990, 1984.Google Scholar
- 7.Kendrick, R.E., Sharma, M.K., Hassler, W.L., Herndon, C.H.: Tarso-metatarsal mobilization for resistant adduction of the forepart of the foot. J. Bone Joint Surg., 52-A:61–70, 1970.Google Scholar
- 9.Kite, J.H.: Congenital metatarsus varus. J. Bone Joint Surg., 49-A:388–397, 1967.Google Scholar
- 11.Meary, R.: Le pied creux essential. Rev. Chir. Orthop., 53:389–410, 1967.Google Scholar
- 12.Peabody, C.W., Muro, G.: Congenital metatarsus varus. J. Bone Joint Surg., 15-A:171–189, 1933.Google Scholar
- 14.Simons, G.W.: Analytical radiography of club feet. J. Bone Joint Surg., 59-B:485–489, 1977.Google Scholar
- 16.Turco, V.J.: Surgical correction of resistant clubfoot. One-stage posteromedial release with internal fixation: a preliminary report. J. Bone Joint Surg., 53-A:477, 1971.Google Scholar