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Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children

Residual deformity in resistant clubfoot is not uncommon. The "bean-shaped foot" exhibits forefoot adduction and midfoot supination and may interfere with function due to poor foot placement. For children less than 5 years of age we describe a corrective procedure combining a closing wedge...

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Main Authors: Mahadev, A., Munajat, I., Mansor, A., Hui, J.H.P.
Format: Article
Language:English
Published: Lippincott, Williams & Wilkins 2009
Subjects:
R Medicine
Online Access:http://eprints.um.edu.my/3328/1/Combined_Lateral_and_Transcuneiform_without_Medial_Osteotomy_for_Residual_Clubfoot.pdf
http://eprints.um.edu.my/3328/
http://pubmedcentralcanada.ca/articlerender.cgi?artid=1593235
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spelling my.um.eprints.33282012-06-19T02:47:00Z http://eprints.um.edu.my/3328/ Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children Mahadev, A. Munajat, I. Mansor, A. Hui, J.H.P. R Medicine Residual deformity in resistant clubfoot is not uncommon. The "bean-shaped foot" exhibits forefoot adduction and midfoot supination and may interfere with function due to poor foot placement. For children less than 5 years of age we describe a corrective procedure combining a closing wedge cuboidal osteotomy and trans-midfoot rotation procedure without a medial opening wedge osteotomy. We retrospectively reviewed twelve patients (14 feet), mean age 4.7 years (range, 4-5 years), who had undergone the procedure to correct forefoot adduction and midfoot supination deformities. We obtained minimal access via a small lateral skin incision. Cuboid lateral wedge osteotomy was followed by transcuneiform osteotomy using a Kirschner wire as a guide under an image intensifier. The minimum followup was 2 years (mean, 2.6 years; range, 2�3.2 years). All patients had qualitative improvement in correction of adduction and supination deformities. Radiographically there was an improvement in adduction deformity, the mean anteroposterior talo-first metatarsal and calcaneo-fifth metatarsal angles improved by 28° (from 40° to 12°) and by 11° (from 21° to 10°). The supination improved by 11° (from 19° to 8°) and the cavus improved by 17° (from 30° to 13°). The short-term outcome was reliable and this combination is useful for children younger than 5 years old where the medial cuneiform ossification center remained poorly defined. Lippincott, Williams & Wilkins 2009 Article PeerReviewed application/pdf en http://eprints.um.edu.my/3328/1/Combined_Lateral_and_Transcuneiform_without_Medial_Osteotomy_for_Residual_Clubfoot.pdf Mahadev, A. and Munajat, I. and Mansor, A. and Hui, J.H.P. (2009) Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children. Clinical Orthopaedics and Related Research, 467 (5). pp. 1319-1325. ISSN 0009-921X http://pubmedcentralcanada.ca/articlerender.cgi?artid=1593235 10.1007/s11999-009-0755-4
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
language English
topic R Medicine
spellingShingle R Medicine
Mahadev, A.
Munajat, I.
Mansor, A.
Hui, J.H.P.
Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
description Residual deformity in resistant clubfoot is not uncommon. The "bean-shaped foot" exhibits forefoot adduction and midfoot supination and may interfere with function due to poor foot placement. For children less than 5 years of age we describe a corrective procedure combining a closing wedge cuboidal osteotomy and trans-midfoot rotation procedure without a medial opening wedge osteotomy. We retrospectively reviewed twelve patients (14 feet), mean age 4.7 years (range, 4-5 years), who had undergone the procedure to correct forefoot adduction and midfoot supination deformities. We obtained minimal access via a small lateral skin incision. Cuboid lateral wedge osteotomy was followed by transcuneiform osteotomy using a Kirschner wire as a guide under an image intensifier. The minimum followup was 2 years (mean, 2.6 years; range, 2�3.2 years). All patients had qualitative improvement in correction of adduction and supination deformities. Radiographically there was an improvement in adduction deformity, the mean anteroposterior talo-first metatarsal and calcaneo-fifth metatarsal angles improved by 28° (from 40° to 12°) and by 11° (from 21° to 10°). The supination improved by 11° (from 19° to 8°) and the cavus improved by 17° (from 30° to 13°). The short-term outcome was reliable and this combination is useful for children younger than 5 years old where the medial cuneiform ossification center remained poorly defined.
format Article
author Mahadev, A.
Munajat, I.
Mansor, A.
Hui, J.H.P.
author_facet Mahadev, A.
Munajat, I.
Mansor, A.
Hui, J.H.P.
author_sort Mahadev, A.
title Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
title_short Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
title_full Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
title_fullStr Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
title_full_unstemmed Combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
title_sort combined lateral and transcuneiform without medial osteotomy for residual clubfoot for children
publisher Lippincott, Williams & Wilkins
publishDate 2009
url http://eprints.um.edu.my/3328/1/Combined_Lateral_and_Transcuneiform_without_Medial_Osteotomy_for_Residual_Clubfoot.pdf
http://eprints.um.edu.my/3328/
http://pubmedcentralcanada.ca/articlerender.cgi?artid=1593235
_version_ 1643687092582088704
score 13.211869

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