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At least 19 recordsLinked to original sources
PubMed1997

[Corrective soft tissue interventions for equinovarus deformity. Foot deformities after tibial compartment syndrome].

Sixty-three patients with rigid equinovarus contractures of the foot following ischemic episodes in the lower leg were treated at our institute from 1983 to 1994 by lengthening the Achilles tendon and the tendon of the m.tibialis posterior, release of the tendons of the m.flexor digitorum longus and the m.flexor hallucis longus and release of the dorsal capsule of the ankle joint. Patients with an equinus deformity greater than 20 degrees, with an additional hind foot varus deformity of more than 5 degrees and/or malrotation of the midfoot were not eligible for this procedure. The initial equinus deformity ranged from 7 degrees to 20 degrees (mean 14 degrees). The clinical and radiological results of 41 patients were evaluated retrospectively with a minimum follow-up of 1 year (mean 3.4 years). The overall results were evaluated according to a modified score of Angus and Cowell. Results were good in 60.9%, fair in 29.3% and poor in 9.8%. The range of motion of the ankle joint and the subtalar and midtarsal joints could not be improved. Postoperative complications were observed in 8 patients, one intraoperative lesion of the posterior tibial artery occurred, one avulsion fracture of the anterior tibial metaphysis and one compression syndrome of the tibial nerve. One patient had an initially incomplete correction with a remaining equinus deformity of 10 degrees, and two recurrences of the foot deformity after initially correct position were observed. Furthermore, two hematomas and two soft-tissue infections required surgical revision. These complications may have been due to the preoperatively scarred soft tissue at the medial aspect of the hind foot and a residual postoperative soft-tissue defect after the correction of the foot deformity had been achieved. In conclusion, the technique described is effective in correcting mild pes equinovarus deformities after ischemic episodes in the lower leg. If the pes equinus deformity is greater than 20 degrees, corrective osteotomies of the hind foot should be performed instead.

Adult↗
PubMed1991

Congenital cleft foot deformity (split foot or lobster claw).

A case of congenital cleft foot deformity, also known as lobster claw or split foot, is presented. The condition is rare. A review of the literature reveals that this deformity will often coexist as part of a constellation of congenital and familial abnormalities. Surgical correction of the cleft foot is difficult and often deferred.

Adult↗
PubMedDate not supplied

A method of dynamic foot-pressure measurement for the evaluation of pediatric orthopaedic foot deformities.

Dynamic foot-pressure measurements are time-sensitive measurements of the pressures under the foot while walking. Historically, many methods are used to measure these pressures; however, current medical literature does not contain a method suitable for the evaluation of pediatric orthopaedic foot deformities. A method for the measurement of dynamic foot pressure for the treatment of pediatric orthopaedic foot deformities was defined in this study. We established the dynamic foot-pressure pattern of a normal population using this method. Dynamic foot-pressure measurements were collected from 54 normal subjects (108 feet). These measurements were divided into the following five segments: the heel, the lateral midfoot, the medial midfoot, the lateral forefoot, and the medial forefoot. Standard tables and graphs were created describing the normal progression of pressure across each segment of the foot while walking. These standard tables and graphs can be used as a reference with which clinical measurements can be compared. This method may be useful as a diagnostic measure of foot deformities and may increase the clinician's ability to measure changes in foot deformity resulting from treatment intervention.

Adolescent↗
PubMed1979

The constant relationship between forefoot and hindfoot as a basis for treating foot deformities.

In correcting foot deformities the author observed a constant relationship between the forefoot and the hindfoot. If the forefoot is adducted, the heel automatically goes into the varus position. On the other hand, abduction of the forefoot will result in a valgus position of the heel. This rule was investigared and validified by experiments on cadavers: it was shown that the position of the hindfoot is automatically normalized by the correction of the forefoot. Our observations have been confirmed by treating foot deformities in children and adults. Therefore we believe that surgery of the talo-calcaneal joint in cases of foot deformity is unnecessary.

Adult↗
PubMed1986

[X-ray diagnosis of foot deformities].

In order to analyze foot deformities, the foot is divided into three compartments. Their normal and pathological positions are defined by the alignment of the bones' axes. The various foot deformities can be put down to a malalignment of the particular compartments. X-ray analysis of the malalignment allows a diagnosis to be made. The most important congenital and acquired foot deformities are discussed.

Calcaneus↗
PubMedDate not supplied

[Assessment of congenital foot deformities].

The assessment of congenital foot deformities is only relevant in the context of German legislation (SchwbG) defining disability and fitness for military service. All assessments of congenital foot deformities should be based on the twin concepts of function and capacity to withstand stress. However, assessments with regard to the degree of disability and fitness for military service will occasionally differ. This article discusses the various congenital foot deformities individually, allocating them to the respective degrees of disability [as laid down in German law]. The classification may serve as a guide for consultants within the context of disability legislation and for ascertaining fitness for military service in accordance with the "Central Standing Orders" of the Federal German armed forces.

Foot Deformities, Congenital↗
PubMedDate not supplied

Foot deformities in arthrogryposis multiplex congenita.

Foot deformities are common in arthrogryposis multiplex congenita. In this group of 52 patients with this diagnosis, 43 had foot deformities. The involvement was bilateral in all cases, and the most common type of deformity was talipes equinovarus (72 feet). The primary treatment in 52 of these patients was operative. Brockmann's procedure was the preferred method during the earlier years and posteromedial or posteromedioplantar release since 1974. Recurrences of the deformity are common; 36 operative procedures were done in 15 feet for recurrence of talipes equinovarus. The primary operative treatment should be extensive enough to correct all components of the deformity. Knee and hip deformity will often influence the outcome. Knee deformities especially cause problems in retaining the desired position of the feet. Talectomy and bone decancellations both seem to be effective in treating recurrences.

Adolescent↗
PubMed1986

Foot deformities in infants and children.

Foot deformities may reflect a generalized disorder, especially a neurologic problem; thus, the child should have a brief general examination. Many infantile foot deformities, such as calcaneovalgus, are postural and self-correcting. Metatarsus varus is not referred for treatment until age 2 months and then only if the deformity is moderate or severe. Fixed forefoot equinus and heel varus characterize a clubfoot, which requires immediate treatment. Corrective shoes are not advised as the primary treatment for metatarsus varus or clubfoot but often are prescribed to maintain the corrected position after serial casts. Flexible flatfoot is a manifestation of a constitutional laxity affecting all ligaments and joints. The feet appear abnormal because of weight-bearing stresses. Most children with flatfoot achieve a partial correction spontaneously. Current research does not document that treatment with corrective shoes or inserts produces a result better than the partial correction that occurs naturally.

Clubfoot↗
PubMedDate not supplied

Survey of foot deformities among 166 geriatric inpatients.

A clinical survey on foot deformities among 166 geriatric inpatients was carried out. Direct measurements on hallux valgus, great toe movements, great toe deformities, lesser toe deformities, arch of the foot, callosities, ankle movements, inversion, and eversion were done by using the goniometer. A specially designed goniometer was created to measure inversion and eversion. The Harris Mat was used to study foot prints in correlation with the various deformities. About 50% of geriatric patients were found to have foot deformities of various types. This compared well with available data in literature. The target population was also checked for their symptomatology which, amazingly, was found to be really insignificant compared with the deformities present. This finding was found to be very much unlike data for Caucasian individuals with foot deformities, 50% of whom had symptoms related to pain and footwear. This major difference in the clinical presentation encourages the authors to carry on their study and, perhaps, direct cross-cultural studies in the future.

Aged↗
PubMed1988

Pathomechanics of structural foot deformities.

This article presents the most common structural foot deformities encountered in clinical practice. The deformities are defined, and the expected compensations at the subtalar joint (STJ) are described. The theoretical consequences of the STJ compensations on proximal and distal tissues are presented. A biomechanical rationale for certain tissue disorders is described. The possible effects of abnormal STJ compensation on osseous development are briefly discussed.

Ankle Joint↗
PubMedDate not supplied

Partial wound closure after surgical correction of equinovarus foot deformity.

Full correction of severe equinovarus foot deformities is frequently lost at the end of surgical release when the surgeon closes the skin incision. We retrospectively review 31 feet in 22 patients whose medial skin incisions were left open (typically 10 mm) to heal by secondary intention. The criterion to leave a wound open was if primary closure with the foot in full correction might compromise circulation to the skin or if closing the incision would require loss of corrected position. One or two cast changes were performed under outpatient anesthesia at 7- to 14-day intervals for wound care. All wounds except one were healed by week 6 at time of outpatient clinic cast removal. The appearance of the incisions is similar to feet in which primary closure is possible. One foot required split-thickness skin grafting at 3 weeks postoperatively to achieve wound coverage. There were no infections. We conclude that primary skin closure is not essential after surgical correction of equinovarus foot deformity, and that correction need not be compromised to approximate skin.

Child↗
PubMed1984

Foot deformities secondary to gluteal injection in infancy.

We report six cases of foot deformities in children due to sciatic nerve dysfunction that appear to have been caused by gluteal intramuscular injection. Of four patients who developed cavovarus foot deformities, two also exhibited a component of ankle equinus. A fifth patient had a calcaneocavus foot deformity. In the sixth patient foot palsy resolved completely 1 year after injury, and no deformities developed. Identification of the muscle imbalance, as well as appropriate correction of the deformity before the implementation of muscle balancing procedures, led to the attainment of a satisfactory plantigrade gait in the first five patients with deformities. Bases on our experience with these six cases and reports in the literature, we recommend that the superolateral gluteal area between the crest of the ilium and the greater trochanter be properly defined as the preferred site for intramuscular injection.

Buttocks↗
PubMed1999

[Soft tissue operations in neuromuscular foot deformities].

The management of neuromuscular foot deformities in children and adolescents must be individualized because of differences in etiology and pathomechanics. If conservative treatment fails or reaches a plateau early soft tissue procedures are recommended. Treatment should focus not only at correction of the deformity but also at reestablishment of muscular balance. Early postoperative mobilisation is usually possible provided adequate orthotic control is maintained. Regular clinical follow-ups help to minimize postoperative problems. The general aim should be an optimization of functions and only rarely to achieve a normal foot. The basic principles of management can be described as correction of deformity, stabilization of unstable joints and balance of muscle power.

Adolescent↗
PubMed1989

Split posterior tibial tendon transfer for spastic equinovarus foot deformity.

This paper describes a simplified technique for split posterior tibial tendon transfer in the treatment of spastic equinovarus deformity of the foot. Thirteen children with spastic equinovarus foot deformities were treated at Children's Rehabilitative Services in Phoenix, Arizona, from 1983 to 1986. The technique was modified in 10 of the 13 patients by attaching the split posterior tibial tendon more proximally to the peroneus brevis, compared to a more distal attachment as described by other authors. The mean length of followup was 21 months. Eleven patients obtained a good or excellent result. Two patients were considered to have a fair result. No poor results or complications were noted in any of the patients. It was felt that the split posterior tibial tendon transfer was an effective procedure for correction of spastic equinovarus as reported by other authors. Modification of the technique significantly simplifies the operation by requiring less dissection while still producing favorable results.

Adolescent↗
PubMed2000

Foot deformities in rheumatoid arthritis and relevance of disease severity.

OBJECTIVE: To investigate foot deformities in rheumatoid arthritis (RA) in relation to the disease severity. METHODS: Radiographs of 100 weight bearing feet of 50 patients who had had RA for >10 years (mean 13.5 years) were studied. The patients were classified into 2 study groups according to the severity of disease. We measured hallux valgus angle (HVA), intermetatarsal angle between first and 2nd (M1/2), and intermetatarsal angle between first and 5th (M1/5) on anteroposterior (AP) radiographs, as well as calcaneal pitch (CP) and first metatarsal pitch (MP) on lateral radiographs. The differences in these angles between the 2 groups (Inter-group study) and the correlations among angles within each group (Intra-group study) were examined. RESULTS: Inter-group study showed significant differences between the 2 groups for all variables. Intra-group study, on the other hand, showed no correlation between variables of the 2 deformities, i.e., splaying of forefoot (M1/2 and M1/5) and flattening of longitudinal arch (CP and MP). Only HVA correlated with the splaying (M1/2 and M1/5) in both study groups. CONCLUSION: Disease severity is related to the progression of foot deformities in RA, but the flattening and the splaying are not correlated with each other. We believe that foot deformities should be treated properly and early, especially for patients who are expected to have severe disease.

Adult↗
PubMed1996

Preventive treatment of foot deformities in type 1 diabetic patients aged 15-50 years--an epidemiological and prospective study.

OBJECTIVES: To prevent worsening of foot deformities in diabetic patients. DESIGN: A population-based and prospective study. SUBJECTS: All patients in the county of Umeå with Type 1 diabetes mellitus (DM) (n = 308) aged 15-50 years. MAIN OUTCOME MEASURES: Examination and individual education was performed. Patients with the most pronounced foot deformities (n = 67) were fitted with custom-made insoles and had repeated foot examinations. An identical examination was used at a 3-year follow-up. RESULTS: Patients who were fitted with insoles had higher sensory thresholds for vibration compared to those with no insoles. They were older and had longer duration of DM. Improvement of foot deformities was significantly more common in patients after treatment with insoles than in patients without. Plantar ulcers did not occur in patients with moulded insoles. CONCLUSION: Information, follow-up examinations and moulded insoles improve neuropathic foot deformities in many patients, even in those with pronounced deformities.

Adolescent↗