Corrective Osteotomies of the Foot
Of the 50,322 compensatable first injuries treated at clinics serving the German commercial trade associations between 1976 and 1979, 6128 were injuries of the foot, and 405 of these involved the ankle joint. The calcaneus was involved in 2012 cases. Injuries of the trasus, metatarsus and phalanges were present in 2750 cases (5.46%, or 9.46% including calcaneal injuries). Injuries of the tibial shaft (2135 = 4.24%) and distal tibia including the malleolar region (3514 = 6.98%), which totaled 5649 cases in this series (11.22%), invariably have effects on the foot as a result of shortening, angulation, malrotation, atrophy, dystrophy, dysfunction or infection, but these effects cannot be dealt with in statistical terms. It is noteworthy that direct (6168) and possible indirect (5649) sequelae of foot injuries together (11,817 = 23.48%) total less than the number of direct hand injuries. The hand, including the distal, articular ends of the radius and ulna, was involved in 12,975 injuries. The tremendous number of corrective operations performed on the hand contrasts with the very few performed on the foot. At our Murnau Clinic we performed only 9 corrective osteotomies of the foot after trauma during the 5-year period from 1978 to 1982. By comparison, 1571 patients were treated with orthopedic (nonprosthetic) footwear for a variety of indications during the period from 1977 to 1981 (1982 not yet evaluated).
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