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VOLUME 9 , ISSUE 4 ( October-December, 2022 ) > List of Articles
Rajyalakshmi N Reddy, Somasekhara R Nallamilli, Venkataramana R Neelam
Keywords : Avoiding toe contractures while correcting foot deformity and foot lengthening, Correction of cavovarus foot deformity in spina bifida with an external fixator, cosmetic foot lengthening, distraction osteogenesis foot lengthening by osteotomy of the bases of all metatarsal bones, extra-articular valgus osteotomy of calcaneum to correct heel varus, joint preservation during foot deformity correction and foot lengthening, medial column lengthening of cavovarus foot with an external fixator, ring fixator vs. uniplanar fixator for foot deformity correction
Citation Information : Reddy RN, Nallamilli SR, Neelam VR. Correction of Talipes Cavovarus with Simultaneous Foot Lengthening in a Spina Bifida Patient. J Foot Ankle Surg Asia-Pacific 2022; 9 (4):192-195.
License: CC BY-NC 4.0
Published Online: 07-10-2022
Copyright Statement: Copyright © 2022; The Author(s).
Background: Spina bifida can leave a permanent foot deformity into adulthood with a difficulty in walking and with a risk of callosities and pressure sores. Arthrodesis surgeries lead to stiff joints with an associated high risk of skin breakdowns. Hence, it is important that any corrective surgery must spare the joints. Extra-articular bony osteotomies and tenotomies are preferred, especially in cases with sensory deficits. Both joint fusions and closed wedge osteotomies share the disadvantage of shortening the foot. This is more relevant in cases where the affected foot is already short; hence, saving the length of the foot is a priority. Case description: A 14-year-old girl presented with a cavovarus foot on the right side, which is short by about 3 cm compared to that on the left side. After soft tissue releases, basal osteotomies of all the metatarsal bones were done, and the medial column was lengthened by distraction osteogenesis. This procedure corrected the forefoot deformity and also helped in increasing the length of the foot by 8 mm. Heel varus needed an Extra-articular osteotomy of calcaneum in a separate procedure. In a follow-up, 6 years after the operation, the patient's foot remained plantigrade though with a mild residual deformity, but the patient is walking well wearing normal shoes. Conclusion: This technique to correct deformity with simultaneous lengthening of the foot is not described before and is suited well for this patient. Surgical treatment of mature deformed feet with special problems needs to be individualized, and in cases like this, we found that our technique is safe and can be considered in similar situations.