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Transcuneiform and opening wedge medial cuneiform osteotomy with closing wedge cuboid osteotomy in relapsed clubfoot.

Ten patients (13 feet) aged 4 to 11 years with idiopathic clubfeet underwent bony correction for resistant supination and adduction deformities. A closing wedge cuboid osteotomy and medial cuneiform opening wedge and transcuneiform osteotomy were performed in all cases. The average improvement in anteroposterior talo-first metatarsal angle of 22 degrees, calcaneo-fifth metatarsal angle of 13 degrees, and lateral calcaneo-first metatarsal of 9 degrees confirmed the clinically satisfactory correction in all feet. However, one foot required repeat surgery 2 years after the index procedure.

Child↗

[Treatment of recurrent or neglected clubfoot by Ilizarov's appliance].

Nine cases of severe, multioperated clubfeet in children and adolescent have been corrected with Ilizarov apparatus. The two first patients have been treated by midtarsal osteotomy plus progressive correction. One poliomyelitic foot have had a slide lengthening of Achilles tendon and a plantar release. Six did not have any open procedure. One ring and two half circles were linked by five threated rods, in order to allow multi axial correction. Seven wires were introduced in the bones; the correction was obtained in a mean time of two months, the device was maintained one more month, then replaced by a walking cast during one month. The results have been seven times satisfactory, with an average follow up of nineteen months after the end of treatment. We did not note any early complication. One more procedure have been performed for flexum of the toes. The ankle range of motion have always been the same as the preoperative one.

Adolescent↗