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- W2740699304 abstract "Metatarsus adductus is a deformity at Lisfranc’s joint in pure transverse plane. It is spontaneously corrected in few months for majority of newborns. In rare cases it demonstrates a clinical stiffness and it results in skewfoot (Z-shaped) in toddler, where valgus of heel creates equilibration of resistant metatarsus adductus. Although, recurrent metatarsus adductus varus is observed in treated idiopathic clubfeet, usually in children over three years, but valgus of the heel when exists is related to surgical overcorrection of heel’s varus. Conservative treatment is advocated in flexible metatarsus adductus, considering manipulations, cast and adequate shoes. Surgery is performed in walking patient when conservative treatment failed. Procedures described in literature considering soft tissue releases, osteotomies of metatarsals and medial epiphysiodesis of metatarsal base gave good results in short term, but they could not avoid recurrence of the deformity and growth disturbance of the foot. Therefore, permanent correction has been obtained with osteotomy proximal to Lisfranc’s joint. Surgical procedures going from opening wedge osteotomy of medial cuneiform, calcaneo-cuboid fusion and resection of anterior end of calcaneus, all act only on one of the sides of deformity. Combining opening wedge osteotomy of cuneiform with closing wedge osteotomy of cuboid described by Jawish allows in metatarsus adductus stiffness a lateral shifting of forefoot. Concerning the associated heel’s valgus, it is thoroughly corrected in Z-shaped foot after double osteotomy cuneiform/cuboid. However, in clubfoot a particular treatment for the posterior tarsal is necessary, because valgus is considered a non-functional deformity related to imbalance at the rearfoot." @default.
- W2740699304 created "2017-08-08" @default.
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- W2740699304 date "2015-01-01" @default.
- W2740699304 modified "2023-09-26" @default.
- W2740699304 title "Annals of Orthopedics & Rheumatology" @default.
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