73: Correction of the Congenital Midfoot Deformity with Osteotomy

Fig. 1

Medial side view of the right foot

Fig. 2

Lateral radiograph of the right foot before surgery

Fig. 3

Posterior view of the both feet

Fig. 4

Plantar view of both feet demonstrates the length discrepancy

Fig. 5

Dorsal view of both feet takes in evidence of adduction of the forefoot

Fig. 6

Clinical lateral view of both feet before treatment

3 Preoperative Problem List

(a)

Varus deformity of the calcaneus

(b)

Cavus deformity of the midfoot

(c)

Adduction and supination of the forefoot

(d)

Shortening of all feet

4 Treatment Strategy

The pre-operative plan included osteotomy of the posterior calcaneus for correction of varus and osteotomy at the level of the cuboid and navicular bone for correction of cavus deformity and adduction and supination of the forefoot.

5 Basic Principles

(a)

Gradual separate correction of the calcaneus with progressive lengthening

(b)

Gradual separate correction of the midfoot in the level of osteotomy and fixation of the fragments of the cuboid and navicular with cutted olive wire for more guided correction of the part of the midfoot

(c)

Fixation of the talus to maintain the relationship in the ankle joint