Soft tissue release combined with joint-sparing osteotomy for treatment of cavovarus foot deformity in older children: Analysis of 21 cases  

作　　者：Zhen-Yu Chen Zhan-Yong Wu Yue-Hui An Li-Fei Dong Jia He Run Chen 

机构地区：[1]The Ninth Department of Orthopedics, Jizhong Energy Xingtai Mining Group General Hospital

出　　处：《World Journal of Clinical Cases》2019年第20期3208-3216,共9页世界临床病例杂志

摘　　要：BACKGROUND Cavovarus foot is a common form of foot deformity in children,which is clinically characterized by an abnormal increase of the longitudinal arch of the foot,and it can be simultaneously complicated with forefoot pronation and varus,rearfoot varus,Achilles tendon contracture,or cock-up toe deformity.Muscle force imbalance is the primary cause of such deformity.Many diseases can lead to muscle force imbalance,such as tethered cord syndrome,cerebral palsy,Charcot-Marie-Tooth disease,and trauma.At present,many surgical treatments are available for cavovarus foot.For older children,priority should be given to midfoot osteotomy and fusion.Since complications such as abnormal foot length,foot stiffness,and abnormal gait tend to develop postoperatively,it is important to preserve the joints and correct the deformity as much as possible.Adequate soft tissue release and muscle balance are the keys to correcting the deformity and avoiding its postoperative recurrence.AIM To assess the efficacy of soft tissue release combined with joint-sparing osteotomy in the treatment of cavovarus foot deformity in older children.METHODS The clinical data of 21 older children with cavovarus foot deformity(28 feet)who were treated surgically at the Ninth Department of Orthopedics of Jizhong Energy Xingtai Mining Group General Hospital from November 2014 to July 2017 were retrospectively analyzed.The patients ranged in age from 10 to 14 years old,with an average age of 12.46±1.20 years.Their main clinical manifestations were deformity,pain,and gait abnormality.The patients underwent magnetic resonance imaging of the lumbar spine,electromyographic examination,weightbearing anteroposterior and lateral X-rays of the feet,and the Coleman block test.Surgical procedures including metatarsal fascia release,Achilles tendon or medial gastrocnemius lengthening,"V"-shaped osteotomy on the dorsal side of the metatarsal base,opening medial cuneiform wedge osteotomy,closing cuboid osteotomy,anterior transfer of the posterior tibial tendon,perBACKGROUND Cavovarus foot is a common form of foot deformity in children, which is clinically characterized by an abnormal increase of the longitudinal arch of the foot, and it can be simultaneously complicated with forefoot pronation and varus,rearfoot varus, Achilles tendon contracture, or cock-up toe deformity. Muscle force imbalance is the primary cause of such deformity. Many diseases can lead to muscle force imbalance, such as tethered cord syndrome, cerebral palsy,Charcot-Marie-Tooth disease, and trauma. At present, many surgical treatments are available for cavovarus foot. For older children, priority should be given to midfoot osteotomy and fusion. Since complications such as abnormal foot length,foot stiffness, and abnormal gait tend to develop postoperatively, it is important to preserve the joints and correct the deformity as much as possible. Adequate soft tissue release and muscle balance are the keys to correcting the deformity and avoiding its postoperative recurrence.AIM To assess the efficacy of soft tissue release combined with joint-sparing osteotomy in the treatment of cavovarus foot deformity in older children.METHODS The clinical data of 21 older children with cavovarus foot deformity(28 feet) who were treated surgically at the Ninth Department of Orthopedics of Jizhong Energy Xingtai Mining Group General Hospital from November 2014 to July 2017 were retrospectively analyzed. The patients ranged in age from 10 to 14 years old,with an average age of 12.46 ± 1.20 years. Their main clinical manifestations were deformity, pain, and gait abnormality. The patients underwent magnetic resonance imaging of the lumbar spine, electromyographic examination, weight-bearing anteroposterior and lateral X-rays of the feet, and the Coleman block test.Surgical procedures including metatarsal fascia release, Achilles tendon or medial gastrocnemius lengthening, "V"-shaped osteotomy on the dorsal side of the metatarsal base, opening medial cuneiform wedge osteotomy, closing cuboid osteotomy, anterior transfer

关 键 词：CHILDREN Cavovarus FOOT MUSCLE BALANCE OSTEOTOMY 

分 类 号：R68[医药卫生—骨科学]