69: Complex Foot Deformity Correction Using V-Shaped Osteotomy and Software-Based Hexapod

Fig. 1

Photographs of patient before surgery

Fig. 2

MAA = 14° (metatarsus adductus )

Fig. 3

Calcaneal tibial angle (frontal plane) = 28° (varus)

Fig. 4

Metatarsus I tibial angle = 22° (dorsiflexion)

Fig. 5

Calcaneal tibial angle (sagittal plane) = 36° (plantar flexion)

3 Preoperative Problem List

There is an ankle joint fusion malunion accompanied with complex (midfoot and hindfoot) multicomponent deformity of the left foot.

4 Treatment Strategy

Performing V-shaped osteotomy.
Applying external fixation for gradual deformity correction.
Midfoot deformity correction should include 10 mm of distraction and 22° of plantar flexion. Total period of correction 24 days (calculated by software).
Hindfoot deformity correction should include 17 mm of distraction, 28° of varization, and 36° of plantar flexion. Total period of correction 46 days (calculated by software).

5 Basic Principles

The indication for a V-shaped оsteotomy is a necessity of simultaneous correction of deformity of the heel and the Chopart joint.

Gradual correction of all deformity components should be done simultaneously in a safe manner.

Use of computer-assisted hexapod (Ortho-SUV Frame) provides precise, one-step gradual deformity correction. Because there was a deformity of midfoot and hindfoot, two hexapods were used.

Use of “Module Transformation” after deformity correction decreases the bulkiness of the frame.