[Cleft foot with Y-shaped deformity of the third metatarsus. A case history.].
OBJECTIVE
Correction of the deformity of the third metatarsus and of the malposition of the toes to improve form and function of the foot.


METHODS
Problems with shoe wear. Aesthetic appearance. (Limitation of function.)


METHODS
None.


METHODS
Drawing of surgery to be performed.


METHODS
Supine. General anaesthesia.


METHODS
Excision of the distal half of the hypoplastic second metatarsus through a curvilinear dorsal incision. Osteotomy of the third metatarsus at the Y-junction and implantation of the mediodistal part into the proximal half of the second metatarsus. Corrective osteotomy of the third metatarsus at the Y-junction. Internal fixation of both metatarsi with transosseous, transarticular Kirschner wires. Four weeks later correction of the hallux valgus using the technique recommended by Kramer.


METHODS
Below knee plaster of Paris. Removal of K'wires after consolidation of osteotomies. Progressive increase in weight bearing. Arch supports.


METHODS
Injury to nerves, vessels or tendons. Wound infection. Delayed consolidation. Nonunion. Growth disturbances.


RESULTS
30 months postoperatively, when the patient was 13 years of age, both osteotomies had healed in good position: the foot looked nearly normal. At 21 years of age the patient has no problems. She is involved in sports and is satisfied with the result.
Blauth
W
W
Orthopädische Universitätsklinik, Michaelisstraße 1, D-24105, Kiel.
Falliner
A
A