[Possibilities of correction of forefoot adduction deformity in children.].
The authors concentrate on surgical approach to adduction deformity of the forefoot in children. They follow 42 children surgically treated - 14 for metatarsus varus and 28 for a residual adduction of the forefoot after treatment for pes equinovarus congenitus. In both groups they compare two operations -Lisfranc joint capsulotomy after Heyman-Herndon-Strong and metatarsal osteotomies after Berman-Gartland. The angle of adduction of the axis I. metatarsal compared to longit. axis of talus has been 35 degrees, both surgical approaches corrected the deformity in a satisfying way, but as more reliable we consider the metatarsal osteotomies, which show a narrow spectrum of postoperational angle values. For structural changes of I. metatarsal base after Heyman capsulotomy we do not consider it a clearly soft tissue operation. As very interesting the authors describe rotation of I. metatarsus round os cuneiforme primum in Heyman capsulotomy, leaving the original articular surface as medial, the lateral side of os cuneiforme primum functioning now as the new articular cuneometatarsal surface. The functional results of surgical treatment of the forefoot adduction deformity in children are satisfactory, as all children fully weight bear without pain. Key words: metatarsus varus, adduction of forefoot, pes equinovarus, Lisfranc capsulotomy, MT osteotomies.
Charvát
J
J
Ortopedická klinika FN, Hradec Králové
Urban
K
K
Peleska
L
L