내반 요족 변형에서 시행한 제1중족골 및 종골에 대한 절골술
Combined First Metatarsal and Calcaneal Osteotomy for Fixed Cavovarus Deformity of The Foot
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge 1st metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-1st metatarsal, calcaneus-1st metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-1st metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of 21° and 25° to 12° and 19°, respectively, at last followup. Also, calcaneus-1st metatarsal angle was increased from the mean 114° to 144°. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
Abstract
Purpose: The aim of this study was to evaluate the result of combined first metatarsal and calcaneal osteotomy for static cavovarus deformity of the foot. Materials and Methods: We performed a dorsal closing wedge 1st metatarsal osteotomy and a lateral and upward displacement calcaneal osteotomy for 9 patients, 12 feet (6 male and 3 female). The mean age at the time of operation was 37 years and the mean followup period was 27 months. The causes of deformity were 2 poliomyelitis, 1 cerebral palsy, 1 Charcot-Marie-Tooth disease and 5 idiopathic type. Five lateral ligament reconstructions of the ankle and six percutaneous Achilles tendon lengthenings were added. The surgical results in terms of pain, function and alignment of the foot were evaluated by means of AOFAS ankle-hindfoot score and talo-1st metatarsal, calcaneus-1st metatarsal and calcaneal pitch angles were checked with weight bearing radiographs in lateral projection. Results: Talo-1st metatarsal and calcaneal pitch angles were reduced from the mean preoperative values of 21° and 25° to 12° and 19°, respectively, at last followup. Also, calcaneus-1st metatarsal angle was increased from the mean 114° to 144°. The mean AOFAS score was improved from 44.5 points preoperatively to 89.2 points at followup. There were 1 metatarso-cueiform joint nonunion, 1 sural nerve injury and 3 remaining symptomatic claw toes. Conclusion: Combined first metatarsal and calcaneal osteotomy appears to be an effective procedure for the treatment of adult static cavovarus foot.
참고문헌 (20)
- Aminian A, "The anatomy of cavus foot deformity", Foot Ankle Clin, 13, pp.191~198 (2008)
- Manoli A 2nd, "The subtle cavus foot, “the underpronator”", Foot Ankle Int, 26, pp.256~263 (2005)
- Younger AS, "Adult cavovarus foot", J Am Acad Orthop Surg, 13, pp.302~315 (2005)
- Schwend RM, "Cavus foot deformity in children", J Am Acad Orthop Surg, 11, pp.201~211 (2003)
- Beals TC, "Charcot-Marie-Tooth disease and the cavovarus foot", Foot Ankle Clin, 13, pp.259~274 (2008)
- Krause FG, "Neuromuscular issues in cavovarus foot", Foot Ankle Clin, 13, pp.243~258 (2008)
- Olney B, "Treatment of the cavus foot. Deformity in the pediatric patient with Charcot-Marie-Tooth", Foot Ankle Clin, 5, pp.305~315 (2000)
- Ward CM, "Long-term results of reconstruction for treatment of a flexible cavovarus foot in Charcot-Marie-Tooth disease", J Bone Joint Surg Am, 90, pp.2631~2642 (2008)
- McCluskey WP, "The cavovarus foot deformity. Etiology and management", Clin Orthop Relat Res, 247, pp.27~37 (1989)
- Ortiz C, "Cavovarus foot reconstruction", Foot Ankle Clin, 14, pp.471~487 (2009)
- Dreher T, "Reconstruction of multiplanar deformity of the hindfoot and midfoot with internal fixation techniques", Foot Ankle Clin, 14, pp.489~531 (2009)
- Sullivan RJ, "Different faces of the triple arthrodesis", Foot Ankle Clin, 7, pp.95~106 (2002)
- Samilson RL, "Cavus, cavovarus, and calcaneocavus. An update", Clin Orthop Relat Res, 177, pp.125~132 (1983)
- Kitaoka HB, "Clinical rating systems for the anklehindfoot, midfoot, hallux, and lesser toes", Foot Ankle Int, 15, pp.349~353 (1994)
- Sammarco GJ, "Cavovarus foot treated with combined calcaneus and metatarsal osteotomies", Foot Ankle Int, 22, pp.19~30 (2001)
- Jahss MH, "Tarsometatarsal truncated-wedge arthrodesis for pes cavus and equinovarus deformity of the fore part of the foot", J Bone Joint Surg Am, 62, pp.713~722 (1980)
- Japas LM, "Surgical treatment of pes cavus by tarsal Vosteotomy.Preliminary report", J Bone Joint Surg Am, 50, pp.927~944 (1968)
- Marks RM, "Midfoot and forefoot issues cavovarus foot:assessment and treatment issues", Foot Ankle Clin, 13, pp.229~241 (2008)
- Wicart P, "Plantar opening-wedge osteotomy of cuneiform bones combined with selective plantar release and dwyer osteotomy for pes cavovarus in children", J Pediatr Orthop, 26, pp.100~108 (2006)
- Coleman SS, "A simple test for hindfoot flexibility in the cavovarus foot", Clin Orthop Relat Res, 123, pp.60~62 (1977)