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Journal articles on the topic 'Feet Deformity'
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1
Vukasinovic, Zoran, Zorica Zivkovic, and Cedomir Vucetic. "Flat feet in children." Srpski arhiv za celokupno lekarstvo 137, no. 5-6 (2009): 320–22. http://dx.doi.org/10.2298/sarh0906320v.
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The authors describe flatfoot, as one of very frequent deformities in everyday medical practice. A special condition of the deformity associated with a calcaneal valgus position and complicated by a knee valgus position (as a consequence of non-treatment) is described. Also, the precise anatomy of the longitudinal foot arches (medial and lateral), definition and classification of the deformity, clinical findings and therapeutic protocols are proposed. The authors especially emphasise that the need for having extensive knowledge on the differences between a flexible and rigid flatfoot, having in mind that the treatment of flexible flat foot is usually not necessary, while the treatment of rigid flatfoot is usually unavoidable.
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Mosawi, Aamir Jalal. "Mowat Wilson Syndrome Associated With Pseudo Rocker Bottom Feet Deformity." Journal of Clinical Research and Reports 2, no. 3 (2020): 01–06. http://dx.doi.org/10.31579/2690-1919/016.
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Bagirov, A. B., B. D. Alinagiev, Fakhri Ogly Teymurkhanly, et al. "Surgical Treatment of Hallux Valgus with Application of External Fixation Device." N.N. Priorov Journal of Traumatology and Orthopedics 17, no. 4 (2010): 75–79. http://dx.doi.org/10.17816/vto201017475-79.
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The experience in treatment of hallux valgus is presented. There were 90 patients, aged 19-77, 199 feet. Seven patients had first degree of deformity, 24 patients - second degree and 59 patients - third degree. Surgical treatment was performed in the period from 2004 to 2009. Depending on the deformity degree various types of osteotomy were applied followed by biomechanically stipulated fixation of bone fragments with small-sized rod and pin-rod external fixation devices. In all patients stable elimination of valgus deformity was achieved. Excellent long-term results were obtained in 67,5% of cases (112 feet), good results in 29,5% (45 feet) and satisfactory results in 3% (5 feet). Neither long-term failed results nor complications were observed. Advantages of surgical treatment of forefoot deformity with external fixation device are the restoration of foot anatomical shape and function in stable fixation of osteotomic fragments without limitations of active functional load on the operated foot.
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Deveci, Alper, Serdar Yilmaz, Ahmet Firat, et al. "An Overlooked Deformity in Patients with Hallux Valgus." Journal of the American Podiatric Medical Association 105, no. 3 (2015): 233–37. http://dx.doi.org/10.7547/0003-0538-105.3.233.
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Background Tailor's bunion is a deformity of the fifth toe, and its concomitance with hallux valgus (HV) is defined as splayfoot deformity. Treatment is focused on the HV deformity in splayfoot, and the tailor's bunion deformity can be overlooked. The frequency of HV concomitant with tailor's bunion in splayfoot has not been reported in the literature. Methods A retrospective evaluation was performed to detect the existence of tailor's bunion deformity in 203 patients (376 feet) treated for HV. Standing anteroposterior and lateral radiographs were used in the radiologic evaluation. Fallat's classification was used to grade tailor's bunion. Surgery for HV was applied to 86 patients (136 feet), and conservative treatment was applied to 117 patients (240 feet). Mean follow-up was 28.3 months (range, 18–42 months). Clinical evaluation was by American Orthopaedic Foot and Ankle Society (AOFAS) score. Results Of the 376 feet with HV, 28 (7.4%) had tailor's bunion, of which 17 (60.7%) were overlooked according to the surgery criteria for tailor's bunion. In the HV surgery group, there were no differences in preoperative mean AOFAS scores according to concurrence with tailor's bunion, but postoperative AOFAS scores were low in patients with accompanying tailor's bunion (P < .001). In the conservative group, no differences were determined in mean AOFAS scores according to tailor's bunion. Conclusions Tailor's bunion deformity sometimes goes undiagnosed in patients with treated HV. This deformity must be kept in mind for patients with HV to improve clinical results.
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Kendić, Sulejman, Nijaz Skender, Amra Ćatović, Naim Čeleš, Indira Dupljak, and Sejdo Ćatović. "Frequency of Feet Deformities in Pupils Attending Junior Grades of Elementary School." Bosnian Journal of Basic Medical Sciences 7, no. 3 (2007): 226–30. http://dx.doi.org/10.17305/bjbms.2007.3049.
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The examination of feet by plantograph was performed in 552 pupils of first, second and fourth grades of elementary school “Harmani II” in Bihać. Examination revealed 201 children (36,42%) with satisfactory condition (pedes recti) while 351 pupils were diagnosed with certain form of feet deformity. Frequencies of feet deformities in girls are 60,00% in first, 65,19% in second and 66,30% in fourth grade. Average frequency of feet deformities in the examined girls is 64,90%. Pedes plani was found in 24,91% pupils. Fequencies of feet deformities in boys are 61,29% in first, 65,54% in second and 52,54% in fourth grade. Average frequency of feet deformities in the examined boys is 62,17%. Pedes plani is the most frequent deformity (23,83%).
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Alsafty, Sameh S., Hassan Saqlain, Kareem S. Khalil, and Gamal A. Hosny. "Talo-calcaneal smile osteotomy as a treatment of rigid residual equinus deformity." International Research Journal of Medicine and Medical Sciences 9, no. 2 (2021): 52–59. http://dx.doi.org/10.30918/irjmms.92.21.017.
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Foot deformities are usually complex. Equinus deformity can be a residual foot deformity element or isolated. A rigid type is the most difficult for treatment. The aim of work is the treatment of rigid equinus deformity by a minimally invasive technique using Ilizarov fixator to restore plantigrade foot and to prevent further recurrence. 17 feet in 14 patients with stiff ankles and rigid equinus after failed surgical correction of club feet, with mean age 6.6 years (4 to 10 years), all treated by smile talocalcaneal osteotomy and Ilizarov ring fixator with a mean follow up 20.9 months (5 to 30 months). 5 feet (29.9%) had excellent results, 8 (47.1%) had good results, 1(5.9%) had a fair result and 3 feet (17.6%) had poor results and underwent revision surgery. In conclusion, our technique Talo-calcaneal smile osteotomy based on distraction osteogenesis method appears to provide similar or better results compared to other literature results without discrimination of foot size, provide some range of motion and plantigrade foot. Keywords: Clubfoot- equinus- rigid -deformity, Ilizarov- Smile osteotomy.
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Horton, Greg A., and Brad W. Olney. "Deformity Correction and Arthrodesis of the Midfoot with a Medial Plate*." Foot & Ankle 14, no. 9 (1993): 493–99. http://dx.doi.org/10.1177/107110079301400902.
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Nine feet in eight patients undergoing tarsometatarsal (Lisfranc) or other midfoot arthrodeses for posttraumatic or degenerative arthritis were reviewed retrospectively. All patients were treated using a medial one-third tubular plate spanning the midfoot joints to be fused. Three feet underwent fusion in situ while six feet underwent correction of residual planus, planovalgus, or cavovarus deformity at the time of fusion. All patients achieved fusion within 12 weeks. A good or excellent result was achieved in seven of nine feet. There was no radiographic or clinical evidence of pseudarthrosis or medial hardware failure in any patient. No patient to date has required hardware removal for a painful or prominent implant. The talus first metatarsal angle was improved an average of 15.5° in the lateral plane and 10° in the AP plane in patients undergoing deformity correction. The technique of using a medial plate for midfoot arthrodesis allows for reliable fusion in patients who require salvage for midfoot arthritis. This technique also allows for correction of deformity in patients with residual midfoot deformity.
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Ryzhov, Pavel V., Nataliya V. Pirogova, Olga D. Bagdulina, and Andrey V. Shmelkov. "Flat and valgus deformation of feet in children: ways of treatment (literature review)." Aspirantskiy Vestnik Povolzhiya 20, no. 5-6 (2020): 114–18. http://dx.doi.org/10.17816/2072-2354.2020.20.3.114-118.
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The article reviews the literature devoted to modern methods of treating children with flat-valgus deformity of the feet. The basic concept, etiology, pathogenesis of the disease, methods of conservative and surgical treatment of feet deformities in children are given, conclusions on the topic are presented, special emphasis has been placed on minimally invasive intervention. Currently one of the most popular methods of surgical correction of flat-valgus deformity of the feet in children is subtalar arthroeresis.
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Abd-Ella, Mohamed Mokhtar. "Talocalcaneal Coalition Resection with Corrective Osteotomies in Symptomatic Adolescents." Foot & Ankle Orthopaedics 4, no. 4 (2019): 2473011419S0008. http://dx.doi.org/10.1177/2473011419s00082.
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Category: Hindfoot Introduction/Purpose: Resection of a symptomatic talocalcaneal coalition in an adolescent without correction of the planovalgus deformity aggravates the problem because the tight peroneal tendons and triceps surae pull the heel into more valgus after release of the subtalar joint. This study aims to evaluate the clinical results of resection of symptomatic talocalcaneal coalition in adolescents with simultaneous correction of the planovalgus deformity using combined bony and soft tissue procedures. Methods: In 24 feet in 21 adolescents (age 13 to 17) with symptomatic talocalcaneal coalition and planovalgus deformity, resection of the coalition was performed together with simultaneous medial displacement calcaneal osteotomy, lateral column lengthening, Cotton osteotomy if needed, gastrocnaemius recession, and peroneal tendon fractional lengthening. Follow up evaluation was done using the AOFAS hindfoot score and subjective patient satisfaction. Complications and reoperation were reported. Results: After a minimal follow up of one year (range 1 to 5 years), the results were classified excellent in 12 feet, good in 8 feet, and fair in four feet using the AOFAS hindfoot score. Subjective patient satisfaction was graded excellent in 14 feet, good in 6 feet and fair in four feet. Two patients underwent subsequent subtalar fusion with subsequent improvement and satisfaction. Other complications included superficial wound problems in 5 feet, and talar incomplete fracture during coalition resection which was fixed in one foot. Conclusion: Resection of a symptomatic talocalcaneal coalition with simultaneous correction of pes planovalgus deformity is a good option for management of such problem in adolescents.
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Kitson, Kathryn. "Bunions: Their Origin and Treatment." Journal of Perioperative Practice 17, no. 7 (2007): 308–16. http://dx.doi.org/10.1177/175045890701700703.
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As theatre practitioners we are on our feet for long periods of time. How many of us can truthfully say that we treat our feet with the respect that they deserve, for example, wearing the correct footwear and generally taking good care of our feet? It is established that theatre clogs, while practical, are not a fashion statement. Most of us probably take our feet for granted - that is until something becomes painful or a deformity occurs. One common and often painful deformity of the foot is a bunion. This article describes how bunions occur and explores the surgical options.
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Porter, R. W., and Karen Youle. "Factors that Affect Surgical Correction in Congenital Talipes Equinovarus." Foot & Ankle 14, no. 1 (1993): 23–27. http://dx.doi.org/10.1177/107110079301400105.
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Children with congenital talipes deformity were assessed photographically at birth, and radiologically prior to a standard staged surgical procedure, carried out by one surgeon. A total of 111 feet of 86 children were assessed clinically and radiologically at 4 years of age. Feet with more deformity at birth and poorer preoperative calf muscle required more surgery and had less satisfactory results. Unilaterally affected feet required less surgery and had significantly better postoperative clinical results than bilaterally affected feet. There was a trend toward poorer results in children with a positive family history of talipes, but gender did not affect the outcome.
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Keenan, Mary Ann E., A. Patricia Gorai, Carl W. Smith, and Douglas E. Garland. "Intrinsic Toe Flexion Deformity Following Correction of Spastic Equinovarus Deformity in Adults." Foot & Ankle 7, no. 6 (1987): 333–37. http://dx.doi.org/10.1177/107110078700700604.
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In the treatment of spastic equinovarus foot deformities in adults with neurologic impairment, various surgical procedures are used including the split anterior tibialis tendon transfer and tendo achillis lengthening. Release of the flexor hallucis longus and flexor digitorum longus tendons in the midfoot is routinely included with these procedures to correct or prevent toe curling. In follow-up, residual toe curling has been observed in some patients despite release of the long toe flexor tendons. This study was undertaken to investigate this problem and its consequences, treatment, and treatment success. Forty-one feet in 34 consecutive patients were examined for residual toe curling an average of 2.5 years postoperatively. Thirty-two feet (78%) were noted to have significant flexion deformities of the lesser toes. The residual toe curling caused pain in 72% of the feet and was associated with callosities on the dorsum of the toes in 59%. The incidence of residual toe curling secondary to spasticity of the flexor digitorum brevis and intrinsic muscles of the foot was similar in the patients who had sustained traumatic brain injury and in those who had suffered a cerebrovascular accident. Twelve of these feet (37%) underwent surgical release of the flexor digitorum brevis and intrinsic tendons to correct the toe curling. There were no complications of surgery and no recurrences of deformity following the surgery. A second surgical procedure to release the flexor digitorum brevis and intrinsic tendons to correct the toe curling was more commonly performed in the younger more active brain-injured patients than in the older stroke patients (44% versus 20%, respectively). The second surgical procedure was also more common in the ambulatory patients compared with the nonambulators (44% versus 14%). Based on the results of this study, we recommend that release of the flexor hallucis longus, flexor digitorum longus, flexor digitorum brevis, and intrinsic tendons be performed at the base of each toe as part of the procedure to correct spastic equinovarus deformities in the adult neurologically impaired patient.
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Ljung, Peter, Jakob Kaij, Kaj Knutson, Holger Pettersson, and Urban Rydholm. "Talonavicular Arthrodesis in the Rheumatoid Foot." Foot & Ankle 13, no. 6 (1992): 313–16. http://dx.doi.org/10.1177/107110079201300603.
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Arthrodesis of the talonavicular joint with a cylindrical dowel was performed in 19 feet in 17 rheumatoid patients with arthritic destruction of the talonavicular joint, but without fixed hindfoot deformity. Osseous union was achieved in 12 feet, but all patients experienced pain relief and no foot showed progressive valgus deformity of the hindfoot during follow-up. Staple fixation seemed to promote osseous union. The procedure, easy to perform and requiring only 6 weeks of immobilization, may, in the absence of fixed hindfoot deformity, supersede triple arthrodesis in rheumatoid patients with hindfoot arthritis.
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Haug, R. H. "Surgical correction of the crow's feet deformity." Journal of Oral and Maxillofacial Surgery 52, no. 3 (1994): 334–35. http://dx.doi.org/10.1016/0278-2391(94)90318-2.
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Mann, David C., and John D. Hsu. "Triple Arthrodesis in the Treatment of Fixed Cavovarus Deformity in Adolescent Patients with Charcot-Marie-Tooth Disease." Foot & Ankle 13, no. 1 (1992): 1–6. http://dx.doi.org/10.1177/107110079201300101.
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Ten adolescent patients with Charcot-Marie-Tooth disease (12 feet) were evaluated an average of 7 years, 7 months following triple arthrodesis (TA) for the treatment of cavovarus deformity. The TA was the primary or index bone procedure. At follow-up, five feet were plantigrade, asymptomatic, and radiographically fused at all three joints. Three feet were plantigrade and asymptomatic, but two had talonavicular pseudarthrosis and one had calcaneocuboid pseudarthrosis. Three feet were radiographically fused at all three joints, but in nonplantigrade positions and symptomatic. One foot required a revision TA. In general, TA offers adolescent Charcot-Marie-Tooth patients a stable plantigrade foot in the face of a progressive disorder. The residual deformity, revision, and pseudarthrosis rates are similar to those for adults. Postoperative pain was related to a nonplantigrade foot and not to the presence of pseudarthrosis. It is not known whether a nonplantigrade foot was a result of incomplete surgical correction or recurrent deformity due to progressive muscle imbalance.
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Trnka, H. J., R. Zettl, M. Hungerford, M. Mühlbauer, and P. Ritschl. "Acquired Hallux Varus and Clinical Tolerability." Foot & Ankle International 18, no. 9 (1997): 593–97. http://dx.doi.org/10.1177/107110079701800913.
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This retrospective study was undertaken to determine the long-term clinical problems, residual disability, and need for further surgery in patients with iatrogenic hallux varus. Between 1975 and 1985, in 16 (19 feet) of 83 patients who underwent foot surgery for hallux valgus or metatarsus primus varus, hallux varus deformity was noted at 1-year follow-up on dorsoplantar roentgenograms obtained with the patients bearing weight. Thirteen of those patients (16 feet) were reexamined at an average of 18.3 years (220 months) after surgery. The average hallux varus deformity in this group was 10.1°. Eleven patients (12 feet) rated their results as excellent. The average hallux metatarsophalangeal interphalangeal score for all patients was 91.5 points. Only those with extreme hallux varus deformity were dissatisfied or required further surgery.
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Cracchiolo, Andrea, Harold B. Kitaoka, and Edward O. Leventen. "Silicone Implant Arthroplasty for Second Metatarsophalangeal Joint Disorders with and without Hallux Valgus Deformities." Foot & Ankle 9, no. 1 (1988): 10–18. http://dx.doi.org/10.1177/107110078800900104.
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Subluxation or dislocation of the second metatarsophalangeal joint (MTPJ) is usually associated with a hammertoe deformity and, frequently, with a significant hallux valgus deformity. Although the joint itself may be painful, there is also pain in the hammertoe deformity, especially when the patient is wearing closed shoes. A painful intractable plantar keratosis is usually present. We reviewed all of our patients with second MTPJ subluxation or dislocation, in whom a double-stem silicone implant had been used to relocate the joint. In 31 feet of 28 patients, 32 implants were used. All but six feet with advanced degenerative joint disease secondary to Freiberg's infraction had severe associated forefoot pathology that necessitated surgical correction. Several feet had previous bunion operations as well as operations on the second toe. In addition to the second toe, we performed hallux valgus corrections in 23 feet, seven of which were revision procedures. At an average follow-up time of 37 months, good results were seen in 20 feet (63%), good results with reservations in eight feet (25%), and failure in four feet (12%). Transfer metatarsalgia was the most frequent complication. The implants remained stable, and in only one was there a suspected fracture. More optimum results might have been achieved had there been better correction of the hallux valgus deformities, more frequent correction of the hammertoe deformity, and less resection of the second metatarsal head. These patients with pathology usually involving both the first and second MTPJ are difficult to treat, therefore. Their results are less predictable and not as favorable as those achieved for patients with isolated similar deformities.
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Sammarco, G. James, and Stephen F. Conti. "Surgical Treatment of Neuroarthropathic Foot Deformity." Foot & Ankle International 19, no. 2 (1998): 102–9. http://dx.doi.org/10.1177/107110079801900209.
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Twenty-seven feet with neuroarthropathic fracture resulting in significant deformity were treated with surgical reconstruction. The average age of the patients was 57 years with 21 patients having diabetes mellitus an average of 24 years. Five patterns of midfoot collapse were identified. The most common patterns involved abduction and dorsal displacement of the forefoot with equinus of the hindfoot. Preoperative evaluation included a medical assessment, adequate control of blood sugar, and a comprehensive vascular evaluation. Five patients presented for surgical consultation with open plantar ulcers. Four were healed with total contact casting alone whereas one patient required an exostectomy to heal the ulcer before surgery. After reconstruction, all feet had improvement in their weightbearing posture. For feet with midfoot involvement, the average anteroposterior talo-first metatarsal angle increased 5°, and the average lateral talo-first metatarsal angle decreased 6.5°. There was no significant loss of correction at long term follow-up. The average time in a cast postoperatively was 5.7 months, and the time to unrestricted weightbearing was 7 months. All patients were able to wear over-the-counter footwear postoperatively. Significant complications included six nonunions and two feet with extension of the neuroarthropathic process. One nonunion required revision surgery, and the feet with extension of their neuroarthropathic fractures required conversion of a triple arthrodesis to a pantalar fusion and the addition of a triple arthrodesis after a successful midfoot fusion. No infections or amputations occurred as a result of the surgery. Function increased and pain decreased as a result of successful arthrodesis. Surgical reconstruction of midfoot, hindfoot, and ankle neuroarthropathic deformity is a viable alternative to amputation for patients who fail nonoperative care. Proper preoperative evaluation and assessment will result in a rate of complications comparable to foot surgery in nondiabetic patients.
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Mukhammadieva, Yu R., A. N. Alshina, I. I. Gainetdinov, and R. F. Safin. "Study of the peculiarities of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination." Russian Osteopathic Journal, no. 2 (July 3, 2021): 41–51. http://dx.doi.org/10.32885/2220-0975-2021-2-41-51.
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Introduction. The relevance of the feet planovalgus deformity problem is caused by its prevalence and tendency to progression, insufficient knowledge of a number of aspects, and the complexity of treatment. Another urgent pediatric orthopedics problem is the placement torticollis in infants, and the possible relationship of this problem with feet planovalgus deformity. Among the least studied aspects of these diseases categories it is necessary to highlight the problem of the peculiarities of the osteopathic status in children with feet planovalgus deformity with a history of placement torticollis, and the dynamics of clinical manifestations during their osteopathic correction.The aim of the research was to study the features of the osteopathic status in patients with planovalgus deformity of the feet in combination with a history of placement torticollis and without such a combination, and to evaluate the clinical efficacy of complex therapy, including osteopathic correction.Materials and methods. The study involved 60 patients aged 7–14 years with planovalgus deformity of the feet. The study participants were divided into two groups. The first group included 30 patients with planovalgus deformity of the feet and a history of placement torticollis. The second group included 30 patients with planovalgus deformity of the feet, who did not have a history of torticollis. All study participants received complex therapy (orthopedic treatment and osteopathic correction). At the beginning and at the end of the course of osteopathic correction, the condition of the arch of the foot (the severity of fl at feet) and osteopathic status were assessed in all study participants.Results. In the first group there were prevailed somatic dysfunctions (SD) of the head region, the detection rate was 86%, the pelvic region (somatic component — C), 76 %, and the neck region (C), 13 %. Among the second group participants there were prevailed SD of the pelvic region (C) — the detection rate was 100 %, the lower extremities, 43 %, and the lumbar region (C), 13 %. The SD in the pelvic region was the most typical; however, more often (p<0,05) this dysfunction was detected in the second group. The number of regional SD in general was statistically significant (p<0,05) more in the first group. The participants in both groups were most characterized by local SD of the vertebrae (76 and 100 %) and fibula (20 and 56 %). There was a statistically significant (p<0,05) difference between patients in terms of the detection frequency of these musculoskeletal system dysfunctions. Among the local SD of the craniosacral system and organs of the head, intraosseous SD (90 and 17 %) and SD of the dura mater (40 and 23 %) prevailed. SD of the temporomandibular joint was detected only in the first group (23 %). There was a statistically significant (p<0,05) difference between the groups in terms of the detection rates of temporomandibular joint dysfunctions and intraosseous dysfunctions. According to the results of treatment, the incidence of SD in the head region and the pelvic region decreased significantly (p<0,05) in patients from the first group, and in the SD of the pelvic region and the region of the lower extremities — in patients from the second group. The severity of flat feet of the study participants was not statistically significantly different before treatment. At the end of the complex treatment, the patients of the both categories showed a statistically significant (p<0,05) improvement in the state of the foot arch.Conclusion. The revealed differences between the participants of the groups in the prevalence and number of regional dysfunctions and the prevalence of local SD could, presumably, reflect the relationship between the placement torticollis and planovalgus deformity of the feet. Based on the absence of differences in the degree of severity of flat feet between the participants of the groups, it can be assumed that the history of the placement torticollis is not associated by itself with the aggravation of the severity of feet planovalgus deformity.
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Dussa, Chakravarthy U., Leonhard Döderlein, Raimund Forst, H. Böhm, and Albert Fujak. "Management of Severe Equinovalgus in Patients With Cerebral Palsy by Naviculectomy in Combination With Midfoot Arthrodesis." Foot & Ankle International 38, no. 9 (2017): 1011–19. http://dx.doi.org/10.1177/1071100717709577.
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Background: Equinovalgus deformity is the second most common deformity in cerebral palsy and may be flexible or rigid. Several operative methods from joint sparing to arthrodesis have been described with varying success rates. The aim of this study was to investigate the effectiveness of naviculectomy in combination with midfoot arthrodesis (talo-cuneiform and calcaneocuboid arthrodesis) in the correction of a rigid equinovalgus foot deformity in cerebral palsy. Methods: Forty-eight rigid equinovalgus feet were operated upon in 30 patients from 2008 to 2013. Of these, 44 feet in 26 patients with cerebral palsy (Gross Motor Function Classification System III, IV, or V) with follow-up of more than 2 years were included in the study. The mean age at surgery was 18.1 years. The outcomes were measured objectively using radiographic angles and subjectively using 5 questions to be answered by the caregiver. The feet were then graded into excellent, good, fair, and poor. The mean follow-up was 5.0 ± 1.7 years. Results: Excellent to good results were obtained in 81% of the feet. Both objective and subjective outcomes improved significantly postoperatively ( P < .001). Three feet in 2 patients were graded as poor and underwent a revision operation for pain and recurrence. Conclusions: Naviculectomy in combination with midfoot arthrodesis enabled a good 3-dimensional correction of the forefoot. However, the procedure did not necessarily correct the fixed subtalar joint deformity. Several additional bony and soft-tissue procedures were necessary to achieve a complete correction in these difficult feet. Level of Evidence: Level IV, retrospective case series.
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Maria Pereira, Jordanna, Ricardo Cardenuto Ferreira, Marco Tulio Costa, Noé De Marchi Neto, Daiana Kerry Gobbo, and Milena Peloggia Cursino Fernandes. "PO 18191 - Congenital distal tibiofibular diastasis." Scientific Journal of the Foot & Ankle 13, Supl 1 (2019): 39S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1027.
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Introduction: Congenital distal tibiofibular diastasis is an extremely rare entity of unknown etiology that compromises the feet and ankles with different degrees of deformity, although in general, the feet show equinovarus deformity, and the talus is proximally dislocated due to the separation of the distal tibial and fibular epiphyses. There are few reports of this disorder in the literature, and most describe cases that ultimately lead to limb amputation. We present the cases of 2 patients treated from birth to skeletal maturity. Methods: Two female patients with clubfoot at birth were diagnosed with congenital distal tibiofibular diastasis. One of them had the deformity of the right foot, and the other had deformity of both limbs. Both patients underwent early distal tibiofibular arthrodesis and serial stretching of the compromised feet and legs. Results: After 20 years of clinical follow-up and after reaching skeletal maturity, both patients had plantigrade feet without significant shortening of the lower limbs or pain, and both performed activities of daily living without restrictions, wearing conventional shoes. Conclusion: Early distal tibiofibular arthrodesis followed by limb stretching was effective for treating congenital distal tibiofibular diastasis and is a good alternative to amputation, which is indicated in the literature.
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Mulier, Tom, Greta Dereymaeker, and Guy Fabry. "Jones Transfer to the Lesser Rays in Metatarsalgia: Technique and Long-Term Follow-Up." Foot & Ankle International 15, no. 10 (1994): 523–30. http://dx.doi.org/10.1177/107110079401501001.
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Thirty-three feet in 29 patients with metatarsalgia were reviewed after Jones transfer to the lesser rays to evaluate the long-term results and the indications for these procedures. Transfer of the long extensor tendons to their respective metatarsal necks and fusion of the interphalangeal joints with shortening of the toe were performed. The procedures were performed in patients with symptoms of metatarsalgia, secondary to anterior pes cavus deformity (clawfeet, 16 patients), and in patients with mild or severe spreadfoot deformity with fall of the central metatarsals (12 patients). In all of our patients, the striking clinical sign was the long toes. Rating of the results was based on (1) the presence of pain or calluses and (2) residual deformity of the forefoot and toes. Symptoms of metatarsalgia were relieved in 25 feet, occasionally present in 6 feet, and unchanged in 2 patients. Complete correction of the deformity was achieved in 26 patients, 6 patients had slight residual deformities, and in the 1 poor result, overcorrection was present after the procedure. This operation is believed to be an excellent choice for patients with metatarsalgia due to (simple) pes cavus deformity and in patients with clawing and metatarsalgia secondary to excessively long toes.
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Weitzel, Stefan, Hans-Joerg Trnka, and Jason Petroutsas. "Transverse Medial Slide Osteotomy for Bunionette Deformity: Long-Term Results." Foot & Ankle International 28, no. 7 (2007): 794–98. http://dx.doi.org/10.3113/fai.2006.0794.
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Background Bunionette deformity of the fifth metatarsal infrequently requires operative treatment. This study presents the long-term results of a simple operative technique. Methods Forty-four distal metatarsal medial slide osteotomies with pin fixation were performed for symptomatic bunionette deformity in 30 patients. After an average of 7 years and 8 months (range 69 to 110 months), 30 feet in 21 patients were available for clinical and radiographic evaluation. Results The patients’ subjective assessment was excellent and good in 81% and fair and poor in 19% of feet. The mean pain score on a visual analogue scale was 1.8 (range 0 to 7) and the mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 88.2 (range 47 to 100). Postoperative complications included pin track infection in three feet and delayed union in one. One patient developed transfer metatarsalgia and another patient had repeat surgery for recurrent symptoms on both feet after 5 years. Conclusions This procedure combines technical simplicity with satisfactory and predictable long-term results in the operative treatment of bunionette deformity in the lateral forefoot.
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Mitrović, Nebojša, and Dalibor Stević. "PREVALENCE OF FOOT DEFORMITY IN PRIMARY SCHOOL CHILDREN." KNOWLEDGE - International Journal 54, no. 4 (2022): 655–59. http://dx.doi.org/10.35120/kij5404655m.
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The frequency of occurrence of acquired flat feet increases with the development of civilization, becausethe gripping function has completely disappeared and today the foot is exclusively used for support. The correctshape and function of the foot directly depends on a properly built bone structure and a good balance of the strengthof the muscles involved in standing and walking. If this balance is disturbed, as a result, the vaults descend. The aimof the work was to analyze the prevalence of lowered foot arches in boys and girls aged 6 to 11 from Bijeljina andBrčko (Bosnia and Herzegovina). The research was transversal in nature, only one measurement was carried out.235 children of both sexes, 111 boys and 124 girls, took part in the analysis of the arches of the feet. The diagnosisof flat feet is based on the valgus position of the heel and the lowered arches of the feet. The subjects' feet werescanned in a standing position with a computer digital podoscope SupOrt. This measuring instrument analyzes thestatus of the arch of the foot in 5 degrees, four degrees refer to a flat foot and one to the so-called indented foot. Theresearch results show a high prevalence of lowered foot arches in the analyzed sample of respondents of 63%. Malerespondents had a significantly higher prevalence of lowered foot arches compared to female respondents. Thisresearch is one of the few that uses a reliable digital computer podoscope to analyze the arches of the feet. Childrenwith increased body mass had a higher prevalence of foot deformities.
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Masashi, Shinohara, Yamaguchi Satoshi, and Ono Yoshimasa. "Anatomical Risk Factors Associated with Rapid Progression of Hallux Valgus Deformity." Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0034. http://dx.doi.org/10.1177/2473011420s00348.
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Category: Bunion; Other Introduction/Purpose: Hallux valgus (HV) deformity generally progresses gradually over the long term. However, the deformity progresses rapidly in some patients. Information on the future progression of the deformity helps treatment decision-making of both surgeons and patients. However, few studies have reported the natural progression of HV deformity. The purposes of this study were to clarify 1) the incidence and 2) anatomical risk factors of the rapid progression of HV deformity. Methods: Patients who visited the foot and ankle clinic of our hospital between 2013 and 2019 were retrospectively analyzed. Inclusion criteria were patients who underwent repeated foot radiographs with an interval of >=2 years. Exclusion criteria were patients <18 years old, history of first ray surgery, deformity or destruction of the first metatarsal head, and unable to stand plantigrade. The increase in HV angle between the baseline and the last follow-up was calculated. Then, patients were dichotomized into two groups: those with an increase in HV angle >=5°(Group P) and those with an increase of <5°(Group S). Radiographic measurements, including HV angle, Hardy’s sesamoid position, distal metatarsal articular angle, rounded metatarsal head, first metatarsal protrusion distance, were performed on the dorsoplantar and lateral foot radiographs at the baseline. The association between the baseline radiographic measurements and progression of HV deformity was assessed using the univariate and multivariate analyses. Results: A total of 268 feet of 268 patients (217 women and 51 men, mean age 61 years) were analyzed. The mean HV angle was 28°, and the mean interval between radiography was 49 months. Forty-five (17%) and 223 (83%) feet were categorized into groups P and S, respectively. The baseline Hardy’s sesamoid position was independently associated with the future progression of the deformity: 6/115 (5%) feet with normal sesamoid (grade <4) were in group P. On the other hand, 39/183 (21%) feet with laterally deviated sesamoid (grade>=4), 39 were in group P (p<0.001). The HV angle at baseline was not associated with the deformity progression (p=0.09). Other measurements, such as rounded metatarsal head, were also not associated with the progression. Conclusion: The rapid progression of HV deformity occurred in 1 out of 6 patients. Furthermore, the lateral deviation of the sesamoid on the dorsoplantar radiograph of the foot may be the risk factor of the rapid progression. For patients with mild deformity but deviated sesamoid, early corrective surgery may be justified to prevent the rapid progression of HV deformity.
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Etani, Yuki, Makoto Hirao, Kosuke Ebina, et al. "Combination of Modified Scarf Osteotomy and Metatarsal Shortening Offset Osteotomy for Rheumatoid Forefoot Deformity." International Journal of Environmental Research and Public Health 18, no. 19 (2021): 10473. http://dx.doi.org/10.3390/ijerph181910473.
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With the progress of medical treatment for rheumatoid arthritis (RA), several joint-preserving forefoot surgical procedures have been established and performed. In this situation, we have been choosing the combined surgery: modified scarf osteotomy for the great toe and metatarsal shortening offset osteotomy for the lesser toes in RA cases. A retrospective observational study of 53 RA patients (mean follow-up period: 4.6 years) who underwent the surgery was completed. RA foot ankle scores were assessed, using the Japanese Society for Surgery of the Foot (JSSF) standard rating system, and a self-administered foot evaluation questionnaire (SAFE-Q) was also checked to evaluate clinical outcomes. For radiological evaluations, deformity parameters were measured using radiographs of the feet with weight-bearing. JSSF hallux and lesser toes scores and the SAFE-Q score showed significant improvement in all indices. HVA, M1-M2A, M1-M5A, M2-M5A, and sesamoid position were significantly improved after surgery. At the final follow-up, the hallux valgus deformity had recurred in 4 feet (7.5%), and hallux varus deformity had developed in 8 feet (15.1%). No case of recurrent hallux valgus deformity required revision surgery. Recurrence of dorsal dislocation/subluxation of the lesser toe MTP joint was seen in 6 feet (11.3%) after surgery. A combination of modified scarf osteotomy for the great toe and modified metatarsal shortening offset osteotomy for the lesser toes is one of the novel surgical procedures for rheumatoid forefoot deformity. Preoperative disease activity of RA negatively affected the clinical score of the hallux. The spread of M2-M5A was a risk factor for resubluxation of the lesser toe MTP joint.
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Gougoulias, Nikolaos E., Filon G. Agathangelidis, and Stephen W. Parsons. "Arthroscopic Ankle Arthrodesis." Foot & Ankle International 28, no. 6 (2007): 695–706. http://dx.doi.org/10.3113/fai.2007.0695.
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Background: Arthroscopic arthrodesis has been used mainly for in situ fusion of arthritic ankles without deformity. This paper presents the application of arthroscopic arthrodesis of ankles with marked deformity. Methods: The results of 78 consecutive cases of arthroscopic ankle arthrodeses, performed in 74 patients, were retrospectively evaluated. Forty-eight ankles had minor deformity (group A), whereas 30 ankles had a varus or valgus deformity of more than 15 degrees (maximum 45 degrees) (group B). The average hospital stay was 3.8 and 3.4 days in groups A and B, respectively ( p = 0.74). Postoperative treatment included ankle immobilization for 3 months. Progressive weightbearing was initiated at 2 weeks. Mean followup was 21.1 months. Results: Fusion occurred in 47 of 48 (97.9%) ankles in group A at an average time of 13.1 ± 5.8 weeks and in 29 of 30 (96.7%) ankles at 11.6 ± 2.4 weeks in group B ( p = 0.19). Unplanned operative procedures were required in 11 ankles (14.1%). One superficial wound infection occurred. Symptomatic arthritis from the adjacent joints developed in six ankles (7.7%). Postoperative ankle alignment in the frontal plane averaged 0.7 and 0.4 degrees of valgus ( p = 0.41), whereas the sagittal plane angle averaged 106 ± 4 degrees and 104.5 ± 7 degrees in groups A and B, respectively ( p = 0.22). The outcome was graded as very good in 79.2% (38 feet) in group A and 80% (24 feet) in group B, fair in 18.8% (9 feet) in group A and 16.7% (5 feet) in group B and poor in one ankle in each group ( p = 0.68). Conclusions: The arthroscopic technique offered high fusion rates and low morbidity. Deformity correction was achieved with good results.
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Wu, Daniel Yiang. "Spontaneous First Metatarsal Rotational Correction by the Syndesmosis Procedure for Hallux Valgus Deformity: A Case Report." Journal of Orthopaedic Case Reports 14, no. 5 (2024): 63–87. http://dx.doi.org/10.13107/jocr.2024.v14.i05.4442.
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Introduction: If not corrected, the first metatarsal pronation rotation deformity is deemed responsible for the high hallux valgus (HV) deformity recurrence rate. Its correction method by osteotomy and arthrodesis has been recommended, just like the metatarsus primus varus (MPV) deformity correction. Since the pathogenesis of the first metatarsal pronation is not well understood, there may be other surgical approaches to correct it. Case Report: A 53-year-old female’s HV feet presented with severe left hallux pronation, and positive radiological round head and inferior tubercle shift signs of the first metatarsal. She underwent a non-osteotomy non-arthrodesis soft-tissue procedure that was expected to correct the MPV deformity but not the pronation deformity. Post-operative hallux pronation was reversed, and round head and inferior tubercle signs were corrected. Conclusion: The first metatarsal hypermobility and displacement of HV feet are probably in all three planes. Correction of MPV in the first metatarsal entirety in the transverse plane without osteotomy or arthrodesis can also induce a correction effect on its sagittal and frontal planes. Keywords: Hallux valgus, metatarsus primus varus, pronation, syndesmosis procedure.
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Zhulikov, A. L., D. A. Malanin, M. V. Demeschenko, I. A. Sutchilin, and S. G. Firsov. "PREVALENCE OF FLATFOOT VALGUS DEFORMITY IN CHILDREN OF THE VOLGOGRAD REGION." Journal of Volgograd State Medical University 19, no. 3 (2022): 108–14. http://dx.doi.org/10.19163/1994-9480-2022-19-3-108-114.
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Flatfoot valgus deformity brings about the formation of overloaded kinetic muscular chains, changes in the biomechanics of feet and overlaying locomotor portions of extremities and vertebral column. The purpose of the study was to reveal the presence and investigate flatfoot valgus deformity in children with platypodia aged 7-14. To study the condition of feet we used the following materials and methods: clinical examination and plantoscopy, podometry, and radiography. The analysis of case histories of podiatric patients aged 7-14 including podometry and plantography findings presented as numerical values, digital photographs of feet and diagnostic conclusions about the type and severity of the pathology was performed. The study has demonstrated that flatfoot valgus deformity associated with a combined type of flatfoot prevails both in boys - in 62 (40 %) and girls - in 38 (24,5 %) cases. The obtained findings have also shown that most children have early stages of valgus deformity, which is observed both in boys in 59 (17) cases and girls in 54 (16) cases. The following conclusions have been made: regular monitoring of foot condition must be performed in children, therapeutic correction of foot static deformities shouLd be made. A weLL-directed programme of exercise therapy and surgicaL treatment of pronounced deformities in chiLdren are required.
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Greisberg, Justin, Sigvard T. Hansen, and Bruce Sangeorzan. "Deformity and Degeneration in the Hindfoot and Midfoot Joints of the Adult Acquired Flatfoot." Foot & Ankle International 24, no. 7 (2003): 530–34. http://dx.doi.org/10.1177/107110070302400704.
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Adult acquired flatfoot is generally characterized by loss of the longitudinal arch, hindfoot valgus, and forefoot abduction, but the precise deformity has not been adequately described at the level of individual joints. Simulated weightbearing CT scans and plain radiographs of 37 symptomatic flat feet were examined in this study. The degree of arthritic degeneration was assessed in the major hindfoot and midfoot joints, and the location of deformity was studied along the medial column of the arch. Moderate to severe degeneration was seen in about one-third of talonavicular, subtalar, and calcaneocuboid joints. The medial column of the arch collapsed through the talonavicular joint in some feet, through the medial naviculocuneiform joint in others, but rarely through both. First tarsometatarsal joint subluxation was a frequent finding as well. In this small series, neither the degree of degenerative arthritis nor the amount of joint deformity was seen to correlate with patient age. Furthermore, no correlation was observed between foot deformity and joint degeneration.
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Kruglov, Igor Yu, Nicolai Yu Rumyantsev, Gamzat G. Omarov, and Natalia N. Rumiantceva. "Change in the severity of congenital clubfoot in the first week of life." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 7, no. 4 (2020): 49–56. http://dx.doi.org/10.17816/ptors7449-56.
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Backgrоund. Congenital clubfoot or congenital equino-cava-varus deformity of the feet is one of the most common pathologies of the musculoskeletal system in children. Numerous articles in global literature have been published about changes in clubfoot severity during treatment; however, there are very few reports on how the severity of foot deformities with congenital clubfoot changes during the first week of life in the absence of deformity correction.
 Aim. To analyze changes in the severity of congenital clubfoot in the first week of life without any treatment.
 Materials and methods. The study group included 28 newborns with idiopathic congenital clubfoot (a total of 40 feet). The severity of clubfoot was evaluated on days one and seven after birth using the Dimeglio and Pirani scores.
 Results. During the initial examination of the newborns on the first day of life, the clubfoot severity recorded on the Pirani score was between 2 to 3 points and between 9 to 15 points on the Dimeglio score. Thus, in the first seven days of life in all patients who did not receive treatment, there was a significant increase in the severity of the equino-cava-varus deformity of the feet (p 0.05). The results of this study confirm that the severity of congenital clubfoot increases in the first week of life. This necessitates the beginning of the correction of severe idiopathic clubfoot in the first days after birth.
 Conclusions. The severity of congenital clubfoot during the first week of life significantly increased in all feet studied (p 0.05: 2 higher than in the table). If left untreated in the first week after birth, the equinus deformity progresses followed by varus deformity, anterior forefoot reduction, and, to a lesser extent, rotation.
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Mirko, Sovilj. "Influence of the Shape of the First Metatarsal Cuneiform Joint on the Development of Hallux Valgus Deformity." Anatomy & Physiology: Current Research 12, no. 3 (2022): 9. https://doi.org/10.35248/2161-0940.22.12.386.
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Objective: To examine the presence of certain shapes of the first Meta Tarsal Cuneiform joint (MTC) joint in feet with Hallux Valgus (HV) deformity. To determine whether the anatomical orientation of this joint affects the size of the hallux valgus angle (HVA) and the first Inter Metatarsal Angle (IMA) and whether it contributes to the dynamics of the developmental course of HV deformity. Methods: The shape of the first MTC joint was determined on a sample of 315 feet with HV deformity. The influence of the shape of this joint on the values of HVA and IMA was explored. The relation between the position of the tibial sesamoid and the size of HVA and IMA as well as the dynamics of the development of this deformity depending on the shape of the first MTC joint was examined. Results: The oblique shape of the first MTC joint was found in 165 (52.4%) feet, the transverse in 145 (46%), and the convex shape was registered in five feet (1.6%). In the oblique shape of this joint, a moderate and severe degree of HV deformity is predominant, while in the transverse shape a mild degree dominates. A statistically significant dependence of HVA on the shape of the first MTC joint was found (Sig.=0.010), while the dependence of IMA did not show statistical significance (Sig.=0.105). HVA values follow the position of the tibial sesamoid in both shapes of the MTC joint while the size of the IMA in the transverse shape does not follow the change of the position of this sesamoid. Conclusion: The oblique shape of the first MTC joint is associated with the more severe form of HV deformity and its faster developmental course. In the analyzed sample, it was shown that HVA is higher in the oblique shape of the MTC joint and significantly depends on the anatomical orientation of this joint. Furthermore, IMA has a higher value in the oblique shape compared to transverse but this dependence is not statistically significant. The analysis showed that the oblique shape of the first MTC joint contributes to the development of HV deformity.. Keywords: Hallux valgus; Etiology; Cuneiform joint
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Suh, Jin Soo, and Jun Young Choi. "Effects of wearing shoes on the feet." Foot & Ankle Orthopaedics 2, no. 3 (2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000382.
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Category: Midfoot/Forefoot Introduction/Purpose: Maasai tribe members either walk barefoot or wearing traditional shoes made from recycled car tires. Despite walking long distances (up to 60 km) daily, they do not generally experience foot ailments. We compared parameters associated with the feet, ankles, and gait of middle-aged partially and regularly shod Maasai women and Koreans. Methods: Foot length, calf circumference, hindfoot alignment, step length, cadence, and walking velocity were compared among 20 middle-aged bush-living partially shod (PS) Maasai women, urban-living regularly shod (RS) Maasai women and Korean. Static and dynamic Harris mat footprints were taken to determine forefoot pressure distribution during walking. We also compared standing foot and ankle radiographic parameters. Results: The mean ratios of foot length to the width were not significantly different among three groups. Claw toe deformity was showed highly in PS (80%) and RS (95%) Maasai women. There were no significant differences in walking velocity and Harris mat findings among the three groups. On comparing PS and RS Maasai groups radiographically, talonavicular coverage angle, talo-first metatarsal angle and naviculo-cuboidal overlap were significantly greater in the PS Maasai group, whereas hallux valgus angle, the first and second intermetatarsal angle Meary angle and the medial cuneiform height were greater in the RS Maasai group. Conclusion: Regularly wearing shoes can protect the feet from fallen medial longitudinal arches with everted hindfeet and abducted midfeet. It could also cause hallux valgus deformity. Claw toe deformity was seen frequently in the Maasai tribe regardless of shoe wearing habits.
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Cavalheiro, Cristina Schmitt, Marcel Henrique Arcuri, Victor Reis Guil, and Julio Cesar Gali. "HALLUX VALGUS ANATOMICAL ALTERATIONS AND ITS CORRELATION WITH THE RADIOGRAPHIC FINDINGS." Acta Ortopédica Brasileira 28, no. 1 (2020): 12–15. http://dx.doi.org/10.1590/1413-785220202801226897.
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ABSTRACT Objective: To describe the anatomical and pathological osteoarticular, muscular and tendinous variations in feet of cadavers with hallux valgus and to correlate them with the degree of radiographic deformity. Methods: Dissections and radiographs were conducted in the feet of 22 cadavers with halux valgus, aged between 20 and 70 years. The feet affected were compared with 5 normal feet in order to document the anatomical and pathological, myotendinous and articular variations found. Results: The extensor hallucis longus and brevis tendons were arched in all degrees of deformity, causing a lateral deviation that forms the arc chord of the metatarsophalangeal angle of the hallux. We also observed a deviation to the plantar face of the abductor muscle tendon and lateral deviation of the flexor hallucis muscle tendon. In the moderate deformities, the medial deviation of the first metatarsal head was observed, sliding out of the sesamoid apparatus, pronation of this head, and formation of medial exostoses. In severe deformities, in addition to all other deformities, we found the extensor hallucis longus tendon with two distal insertions, rather than just one. Conclusion: The anatomical alterations found in the hallux valgus may be related to the degree of radiographic deformity . Level of Evidence IV, Case series.
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S.A., Vinukov, Chernomortseva E.S., Chernomortsev S.E., and Chueva T.V. "ACTUAL ASPECTS OF ANATOMICAL AND FUNCTIONAL CHANGES OF FLAT – VALGUS DEFORMITY OF THE FOOT IN CHILDREN." ИННОВАЦИОННЫЕ НАУЧНЫЕ ИССЛЕДОВАНИЯ 2023. 1-2(25) (February 5, 2023): 15–23. https://doi.org/10.5281/zenodo.7607834.
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Flat-valgus deformity of the foot is one of the most common diseases of the feet in children and adolescents. The article indicates the anatomical and physiological prerequisites for the development of various types of flat feet. The pathogenesis of the disease, the causes of development, the main symptoms, possible complications, features of diagnosis and conservative treatment of flat feet in childhood are considered in detail.
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McGarvey, Scott R., and Kenneth A. Johnson. "Keller Arthroplasty in Combination with Resection Arthroplasty of the Lesser Metatarsophalangeal Joints in Rheumatoid Arthritis." Foot & Ankle 9, no. 2 (1988): 75–80. http://dx.doi.org/10.1177/107110078800900203.
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We reviewed the results of the Keller arthroplasty in combination with resection arthroplasty of the forefoot in patients with rheumatoid arthritis. Of the 29 patients (49 feet) in the series, 20 had involvement of both feet and nine had involvement of a single foot. The average age of the patients was 55.4 years, and the average follow-up period was 4.9 years. All feet had resection of the lesser metatarsal heads, resection of the base of the proximal phalanges of the lesser toe, and a Keller arthroplasty of the first metatarsophalangeal joint. The results were satisfactory in 16 feet, satisfactory with some reservations in 21 feet, satisfactory with major reservations in seven feet, and unsatisfactory in five feet. For 40 of the 49 feet (82%), the patients stated that they would repeat the procedure, knowing the results achieved. The major causes of patient reservations and lack of satisfaction were return of the hallux valgus deformity and pain (53%), forefoot instability (27%), and continuing metatarsalgia (20%). Resection arthroplasty of the lesser metatarsophalangeal joints of the forefoot in rheumatoid disease is a satisfactory procedure. When used in combination with Keller resection arthroplasty of the first metatarsophalangeal joint, however, an increased number of unsatisfactory results occur, attributable to returning pain and deformity of that joint.
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Sandeep, Rana, C. Patil Sandesh, and Karur Kailash. "A Prospective Study on Treatment of Idiopathic Clubfoot by Ponseti Method." International Journal of Pharmaceutical and Clinical Research 16, no. 5 (2024): 375–78. https://doi.org/10.5281/zenodo.11402179.
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<strong>Background: </strong>From long time clubfoot has been a clinical challenge to orthopaedic surgeons. It is one of the commonest congenital deformity of the musculoskeletal system in children. Each year more than 1,00,000 babies are born with congenital clubfoot. 80% of which occur in developing countries. <strong>Methods: </strong>Data collected from the Department of Orthopaedics, Sanjay Gandhi Institute of Trauma and Orthopaedics, Bengaluru 60 feet in 40 children were treated by the Ponseti method from September 2022 to august 2023. Prospective follow up for a mean duration of 18 months was undertaken. The deformity was evaluated by Pirani score before and after the treatment. At the end of treatment all feet were functionally classified into good, fair and poor. <strong>Results: </strong>The average number of casts applied before full correction was 8. 21.66% of the feets needed tenotomy before full correction. 90% of the patients showed good results, 3.3% had fair results and 6.6% of patients had poor results. There was a significant difference in the pre-treatment and post-treatment pirani score values. <strong>Conclusions: </strong>Ponseti method of manipulation and plaster casting is very effective to correct club foot deformity.
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MM, Bari, Novikov Konstantin, Islam Shahidul, et al. "Technique for correction of combined burnscar deformity of foot." MOJ Orthopedics & Rheumatology 14, no. 2 (2022): 48–50. http://dx.doi.org/10.15406/mojor.2022.14.00577.
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The post burn deformity is a mixed plastic and orthopedic problem that impairs limb function and needs complex treatment. This essay reports a novel surgical treatment procedure performed for a patient with combined burn scar deformity of the dorsum of the feet and toes. The surgical intervention included excision of coarse scars on the dorsal aspects of toes and both feet, autologous full thickness skin grafting of cutaneous defects, and bilateral treatment of subluxated metatarsophalangeal joints (MTPJ) using Ilizarov external xation. Finally, deform toes were corrected, and the old scars were removed replaced with new skin layers.
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Gordon, David, Thomas L. Lewis, and Robbie Ray. "Minimally Invasive Surgery for Severe Hallux Valgus with 2 Year Minimum Follow Up in 106 Feet." Foot & Ankle Orthopaedics 7, no. 1 (2022): 2473011421S0002. http://dx.doi.org/10.1177/2473011421s00028.
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Category: Bunion; Lesser Toes; Midfoot/Forefoot Introduction/Purpose: There is widespread variation in the optimal procedure for correction of severe hallux valgus deformity. Severe hallux valgus (defined as hallux valgus angle (HVA) (>=40°) and/or 1-2 intermetatarsal angle (IMA) (>=20°)) is associated with increased complication rates including recurrence, delayed or non-union and metatarsal shortening with transfer metatarsalgia. There is limited evidence investigating the clinical or radiological outcomes following treatment of severe hallux valgus deformity with third-generation minimally invasive chevron and akin osteotomies (MICA). Objective: The primary aim was to investigate clinical patient reported outcome measures (PROMs) two years following surgery and the radiographic deformity correction for patients undergoing third-generation MICA for severe hallux valgus deformity. Methods: Prospective observational single surgeon series of consecutive patients who underwent primary third-generation MICA with screw fixation for severe hallux valgus. The primary outcome was a validated patient reported outcome measure, the Manchester-Oxford Foot Questionnaire (MOXFQ), assessed minimum 2 years following MICA. Secondary outcomes were radiographic deformity correction, complication rates and other quality of life PROMs (EQ-5D and Visual Analogue Pain Scale). Results: Between September 2014 and May 2018, 106 consecutive feet (n=78 patients; 73 female, 5 male) met the inclusion criteria. Prospectively collected pre-operative and 2 year PROM MOXFQ data was available for 86 feet (81.1%). At two years following surgery, the MOXFQ score significantly improved for the Pain, Walking and Standing and Social Interaction domains from 39.2 to 7.5, 38.2 to 5.9 and 48.6 to 5.5, respectively (p<0.001). Pre- and post-operative radiographic data was available for all 106 feet. Mean IMA following surgery improved from 18.2° to 6.3° (p<0.001) whilst mean HVA improved from 45.3° to 10.9° (p<0.001). Conclusion: This study has demonstrated third-generation MICA for the treatment of severe hallux valgus deformity can achieve significant improvements in clinical PROMs and radiographic deformity correction.
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Shulga, O. "COMPARATIVE EVALUATION OF SURGICAL TREATMENT METHODS OF RIGID FLAT FEET IN CHILDREN WITH DYSFUNCTION OF THE POSTERIOR TIBIALIS TENDON." Neonatology, surgery and perinatal medicine 10, no. 4(38) (2020): 46–52. http://dx.doi.org/10.24061/2413-4260.x.4.38.2020.5.
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Introduction.The rigid form of static flat feet in children occurs in 18-20 % of cases of the musculoskeletal system pathology. Nowadays, neither objective diagnostic methods have been developed, nor algorithms for treating the rigid form of flat feet depending on the severity, deformity of the tarsal bones, foot mobility and dysfunction of the posterior tibialis tendon (PTT) have been found.
 Objective. To develop objective evaluation methods of rigid flat feet surgical treatment in children depending on the joints’ mobility, compression ratio, and PTT dysfunction stage.
 Methods and materials. The effectiveness of the rigid form of static stage II-III flat feet treatment was analysed in 15 children aged 14 to 18 years, who were divided into control and main groups. Clinical and radiological diagnostic methods were used. Patients of the control group (8 children) were operated using subtalar arthroereisis method. Patients of the main group (7 children) underwent surgery on bones and soft tissues.
 Results. Surgical treatment showed no effect using subtalar arthroereisis method in cases of the tarsal bone deformity, advanced stage of PTT dysfunction, and significant impairment of foot mobility. Positive results were also achieved using two-joint arthrodesis with the formation of navicular-tibial ligament with severe foot rigidity, stage III-IV of PTT dysfunction and navicular bone deformity.
 Conclusion. During treatment of rigid flat feet in children it’s necessary to take into consideration severity, compression ratio of the navicular bone, the mobility index, the stage of the posterior tibialis tendon dysfunction and the angle of its tension. Long-term results indicate the effectiveness of surgery on bones and soft tissues in the treatment of severe rigid flat feet.
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Ettl, Volker, Nicole Wollmerstedt, Stephan Kirschner, Robert Morrison, Eva Pasold, and Peter Raab. "Calcaneal Lengthening for Planovalgus Deformity in Children with Cerebral Palsy." Foot & Ankle International 30, no. 5 (2009): 398–404. http://dx.doi.org/10.3113/fai-2009-0398.
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Background: In children with cerebral palsy, planovalgus deformity of the foot is common. The aim of this study was to evaluate the outcome of calcaneal lengthening for the treatment of planovalgus foot deformity in children with cerebral palsy. Materials and Methods: We reviewed 19 children (28 feet) treated between 1996 and 2004 in our institution. There were 14 ambulating (19 feet) and 5 nonambulating children (9 feet). The average age of the children at time of surgery was 8.6 years. Followup averaged 4.3 years. Results: We found satisfactory results in 75% of the feet clinically and in 79% radiologically according to Mosca's criteria. We saw no overcorrection but a relapse of the deformity in seven cases. There were six unsatisfactory radiological results, two (out of 19) in the ambulating and four (out of nine) in the nonambulating group. Ambulating children had a significantly better clinical and radiological outcome than nonambulating children ( p = 0.042). A significant correlation was found between Ankle-hindfoot Score and clinical result according to Mosca's criteria ( p = 0.001). Conclusion: In ambulatory children with cerebral palsy calcaneal lengthening is an effective procedure for the correction of mild to moderate planovalgus foot deformities. In nonambulatory children with severe plano-valgus deformities of the foot, calcaneal lengthening cannot be recommended because of the high relapse rate in these patients.
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Pasapula, Chandra Seker, Makhib Rashid Choudkhuri, Eva R. Gil Monzó, et al. "Review of Classification Systems for Adult Acquired Flatfoot Deformity/Progressive Collapsing Foot Deformity and the Novel Development of the Triple Classification Delinking Instability/Deformity/Reactivity and Foot Type." Journal of Clinical Medicine 13, no. 4 (2024): 942. http://dx.doi.org/10.3390/jcm13040942.
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Background: Classifications of AAFD/PCFD have evolved with an increased understanding of the pathology involved. A review of classification systems helps identify deficiencies and respective contributions to the evolution in understanding the classification of AAFD/PCFD. Methods: Using multiple electronic database searches (Medline, PubMed) and Google search, original papers classifying AAFD/PCFD were identified. Nine original papers were identified that met the inclusion criteria. Results: Johnson’s original classification and multiple variants provided a significant leap in understanding and communicating the pathology but remained tibialis posterior tendon-focused. Drawbacks of these classifications include the implication of causality, linearity of progression through stages, an oversimplification of stage 2 deformity, and a failure to understand that multiple tendons react, not just tibialis posterior. Later classifications, such as the PCFD classification, are deformity-centric. Early ligament laxity/instability in normal attitude feet and all stages of cavus feet can present with pain and instability with minor/no deformity. These may not be captured in deformity-based classifications. The authors developed the ‘Triple Classification’ (TC) understanding that primary pathology is a progressive ligament failure/laxity that presents as tendon reactivity, deformity, and painful impingement, variably manifested depending on starting foot morphology. In this classification, starting foot morphology is typed, ligament laxities are staged, and deformity is zoned. Conclusions: This review has used identified deficiencies within classification systems for AAFD/PCFD to delink ligament laxity, deformity, and foot type and develop the ‘Triple classification’. Advantages of the TC may include representing foot types with no deformity, defining complex secondary instabilities, delinking foot types, tendon reactivity/ligament instability, and deformity to represent these independently in a new classification system. Level of Evidence: Level V.
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Vlasov, Maksim Valer'evich, A. B. Bogos'yan, N. A. Tenilin, M. V. Vlasov, A. B. Bogos'yan, and N. A. Tenin. "Surgical Correction of Congenital Planovalgus Foot Deformity in Children." N.N. Priorov Journal of Traumatology and Orthopedics 18, no. 4 (2011): 23–26. http://dx.doi.org/10.17816/vto201118423-26.
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During the period from 2002 to 2008 seventeen children with III degree of congenital planovalgus foot deformity (29 feet) were operated on at orthopaedic department of Nizhniy Novgorod Scientific Research Institute of Traumatology and Orthopaedics using new technique of surgical correction. In all cases long term results were assessed within the period from 3 to 10 years after operation. Good and satisfactory results were achieved in 21 and 8 feet, respectively. Neither poor results nor recurrences were observed.
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Vinderlikh, M. E., and N. B. Shchekolova. "A modern approach to the treatment of scoliosis with skewed pelvic bones by correcting asymmetric mobile planovalgus deformity of the feet." Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) 13, no. 6 (2024): 96–102. http://dx.doi.org/10.20340/vmi-rvz.2023.6.clin.10.
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Introduction. The treatment of combined pathology of posture and feet remains an urgent problem of the child population.Target. To study the effectiveness of using an individually made wedge-shaped corrective heel pad for each foot in the treatment of grade I-II scoliosis with pelvic bone distortion due to asymmetric mobile flat-valgus deformity of the feet for 3 years.Object and methods. A comparison group and a main group were formed from 39 children and adolescents aged 3 to 15 years with grade I-II scoliosis with skewed pelvic bones and mobile flat-valgus deformity of the feet; patients underwent orthopedic examination every 6 months, radiography of the spine with pelvic bones, photoplantography, measurement of the pronation angle of the calcaneus, the study of quality of life indicators.Results. There was a decrease in clinical symptoms in 54.2 % of patients of the main group with regression of the II degree of scoliosis to the I degree, the pronation angle of the calcaneal bones decreased by 4.25 ± 0.78 ° with the preservation of minimal asymmetry after 3 years, a decrease in the difference of the iliac crests by 3 .64 ± 1.59 mm and the angle of scoliotic deformity of the spine on radiographs by 5.22 ± 1.36°. Correlation analysis showed a statistically significant strong and moderate direct relationship between the pronation angle of the left calcaneus and the angle of scoliotic spinal deformity on radiographs in the 1st and 3rd years of the study, as well as with the difference in the iliac crests throughout the study. The quality of life of patients of the main group with correction of the asymmetry of foot hyperpronation improved by 15.5 %, in the comparison group by 2.9 %.Conclusions. The results of the study confirmed the effectiveness of the use of individual wedge-shaped corrective heel pads for each foot in the treatment of grade I-II scoliosis with skewed pelvic bones due to asymmetric mobile flat-valgus deformity of the feet.
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Mathew, Pradeep George, Pavel Šponer, Jaroslav Pavlata, and Haroun Hassan Shaikh. "Our Experience with Double Metatarsal Osteotomy in the Treatment of Hallux Valgus." Acta Medica (Hradec Kralove, Czech Republic) 55, no. 1 (2012): 37–41. http://dx.doi.org/10.14712/18059694.2015.73.
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Adolescent hallux valgus (HV) is a progressive deformity of adolescent age consisting of metatarsus primus varus and hallux valgus. It has a high recurrence rate after conventional surgical correction. Ten feet in nine patients (two males, seven females) were treated surgically with the Peterson Newman bunion procedure, with a minimum follow‑up of one year. During the final follow‑up all these patients had no complaints of pain, joint stiffness or limping. Even though the patients had some mild loss of range of movements at the MTP joints 4–6° compared to preoperative value, it did not cause any functional impairment and all were satisfied with the final outcome. The double ostetomy for treatment of hallux valgus is technically precise procedure, provides excellent correction and stability and has low rate of recurrence of deformity. We had an excellent outcome in 10 feet in our study without residual deformity or complications.
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Ansah-Twum, Jeremy, Mingjie Zhu, Melissa L. Carpenter, et al. "Tarsal Coalition is Not Necessarily Associated with a Flatfoot Deformity: A Cohort of Clinically Misdiagnosed Cases and Alignment Features in 41 Feet." Foot & Ankle Orthopaedics 7, no. 4 (2022): 2473011421S0055. http://dx.doi.org/10.1177/2473011421s00559.
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Category: Hindfoot; Ankle; Midfoot/Forefoot Introduction/Purpose: Tarsal coalition has been historically reported to be associated with a flatfoot deformity. There are however case reports demonstrating that it can be found in cavovarus and clubfoot deformities. The goal of this study was to retrospectively review all weightbearing CT (WBCT) scans that were taken in one medical center, to investigate the clinically diagnosed as well as missed cases of tarsal coalition, and to determine the hindfoot alignment and arch height features of each case. Methods: 800 WBCT scans were reviewed separately by two senior fellowship trained foot and ankle surgeons. The structure of the hindfoot and midfoot was carefully examined in all three views to screen for different types of tarsal coalition. For cases that were diagnosed with tarsal coalition on WBCT, the medical charts were then reviewed to determine the original clinical diagnoses. Hindfoot alignment and arch height features of the midfoot were subsequently evaluated on WBCT scans. Results: There were 41 feet that were diagnosed with tarsal coalition on WBCT (Figure 1). The clinical diagnosis of coalition was only made in 15 feet and 26 symptomatic feet were clinically missed. Among the 26 symptomatic feet diagnosed on WBCT but clinically missed, 16 had a clinical diagnosis of congenital or acquired flatfoot, 3 with subtalar arthritis, 1 with talonavicular arthritis, 1 with peroneal tendinopathy and a cavovarus foot deformity, 2 with cavovarus deformity and midfoot arthritis, 2 with posttraumatic ankle arthritis, and 1 with subtalar impingement. A valgus hindfoot was found in 19 feet, a neutral hindfoot in 18, and a varus hindfoot in 4 feet. In the midfoot, 38 feet had a positive (>=1) distal medial cuneiform/fifth metatarsal arch height index, and 3 feet had a negative index (<1); all 41 feet had a positive proximal cuneiform/cuboid height index (>=1). Conclusion: One should be aware that patients with tarsal coalition do not always present with a flatfoot and hindfoot valgus, since many can have a variety of hindfoot and midfoot alignment features. In cases presenting with history of trauma, degenerative arthritis, as well as a cavovarus or clubfoot deformity, tarsal coalition can easily be clinically overlooked. References: - Lemley F, Berlet G, Hill K, Philbin T, Isaac B, Lee T. Current concepts review: Tarsal coalition. Foot Ankle Int. 2006 Dec;27(12):1163-9. - Van Rysselberghe NL, Souder CD, Mubarak SJ. Unsuspected tarsal coalitions in equinus and varus foot deformities. J Pediatr Orthop B. 2020 Jul;29(4):370-374.
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Segal, Lee S., David C. Mann, Earl Feiwell, and M. Mark Hoffer. "Equinovarus Deformity in Arthrogryposis and Myelomeningocele: Evaluation of Primary Talectomy." Foot & Ankle 10, no. 1 (1989): 12–16. http://dx.doi.org/10.1177/107110078901000103.
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As initial surgical management for rigid equinovarus deformities, 16 children with arthrogryposis (30 involved feet) and 16 myelodysplastic children (26 involved feet) underwent primary talectomies or extensive posterior-medial releases (PMR). When compared with primary PMRs in arthrogrypotic children, primary talectomies revealed a greater number of good and fair results, decreased recurrence rates, less procedures per foot, and maintenance of ambulatory status. Recurrent forefoot and cavus deformities were present after primary talectomies. Primary talectomy in arthrogrypotic children was more effective than posterior-medial releases or secondary (salvage) talectomy. Because of the small number of feet involved, the role of primary talectomy in myelomeningocele was not clarified by this study. Radical PMRs in myelodysplastic children resulted in a significant number of hindfoot valgus deformities that required secondary procedures.
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Ryu, Min-Hee, David Kahng, and Yongho Shin. "Surgical Correction of Crow's Feet Deformity With Radiofrequency Current." Aesthetic Surgery Journal 34, no. 1 (2014): 28–33. http://dx.doi.org/10.1177/1090820x13515271.
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Chambers, Monique C., Dion Birhiray, Mina A. Botros, and William M. Granberry. "Metatarsal Pronation: Does It Matter?" Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0015. http://dx.doi.org/10.1177/2473011420s00159.
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Category: Bunion Introduction/Purpose: Hallux Valgus is a complex deformity with several attendant components that are present to varying degrees in each patient. Historically primary attention has been paid to correction of the coronal plane deformity, but recent investigations suggest a substantial contribution to the deformity from the axial rotational abnormality of the metatarsal. While the effect of this metatarsal pronation has been demonstrated, the relative contribution of this parameter compared to other components has not been considered. This study aims to investigate the rotational aspect of the deformity and its contribution to successful radiographic correction of the deformity. Methods: A retrospective review of 100 consecutive Lapidus bunionectomy procedures was performed. There were 80 of patients and 89 feet. patients <18yrs, revision surgery and combined surgery, other than forefoot procedures were excluded. There were 79 (88%) females and 10 (12) males. The mean age was55. All feet were followed till radiographic healing was complete. Each foot was examined radiographically and pre and post-operative findings were compared. Along with the typical measurements of Hallux valgus parameters in the coronal plane, an additional measurement was included to estimate metatarsal head pronation (MT head shape and sesamoid position). The radiographic outcomes were then compared to determine the independent effect of metartarsal rotation on outcomes (recurrence, time to fusion). Pearson correlation was utilized to determine significant associations with the outcome parameters for recurrence, time to fusion, and failure to correct the hallux valgus angle (HVA). Results: The average HVA correction was 20.08 degrees and 6.86 degrees for IMA. A total of 68 feet had a positive preop round head sign and correction to a normal MT head shape was observed in 47 feet. A significant increase in recurrence was associated with patients that had persistent MT round sign following correction (p=0.001) and in patients with a higher sesamoid position in the preop period p<0.001). The average time to fusion was 9.56 with 47 (52%) feet were healed at 6 weeks postop. A higher (more lateral) sesamoid position and a higher postop HVA were also associated with longer time to fusion or delayed union. Conclusion: Adequate preoperative radiographic assessment is of the utmost importance to assess the various forces that can contribute to hallux valgus deformity. Newer techniques address coronal and sagittal plane deformity. Failure to correct MT head pronation may lead to increased hallux valgus recurrence, despite sagittal correction measured by improvement of the HVA and IMA angles. Factors that impact time to fusion are also associated with a higher risk of HV recurrence. Sesamoid position and metatarsal head pronation should be considered, and correction of these parameters may be necessary to avoid delayed healing and persistent or recurrent HV.
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Wu, Daniel Y., and Eddy K. F. Lam. "Revisiting the radiological signs for the first metatarsal pronation assessment." Bone & Joint Open 5, no. 11 (2024): 1037–40. http://dx.doi.org/10.1302/2633-1462.511.bjo-2024-0116.r1.
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AimsThe first metatarsal pronation deformity of hallux valgus feet is widely recognized. However, its assessment relies mostly on 3D standing CT scans. Two radiological signs, the first metatarsal round head (RH) and inferior tuberosity position (ITP), have been described, but are seldom used to aid in diagnosis. This study was undertaken to determine the reliability and validity of these two signs for a more convenient and affordable preoperative assessment and postoperative comparison.MethodsA total of 200 feet were randomly selected from the radiograph archives of a foot and ankle clinic. An anteroposterior view of both feet was taken while standing on the same x-ray platform. The intermetatarsal angle (IMA), metatarsophalangeal angle (MPA), medial sesamoid position, RH, and ITP signs were assessed for statistical analysis.ResultsThere were 127 feet with an IMA > 9°. Both RH and ITP severities correlated significantly with IMA severity. RH and ITP were also significantly associated with each other, and the pronation deformities of these feet are probably related to extrinsic factors. There were also feet with discrepancies between their RH and ITP severities, possibly due to intrinsic torsion of the first metatarsal.ConclusionBoth RH and ITP are reliable first metatarsal pronation signs correlating to the metatarsus primus varus deformity of hallux valgus feet. They should be used more for preoperative and postoperative assessment.Cite this article: Bone Jt Open 2024;5(11):1037–1040.