Operative Orthopadie und Traumatologie · 1997
[Cleft foot with Y-shaped deformity of the third metatarsus. A case history.].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Blauth W, Falliner A
Аннотация
GOAL OF SURGERY: Correction of the deformity of the third metatarsus and of the malposition of the toes to improve form and function of the foot.
INDICATIONS: Problems with shoe wear. Aesthetic appearance. (Limitation of function.)
CONTRAINDICATIONS: None.
PREOPERATIVE WORK UP: Drawing of surgery to be performed.
POSITIONING AND ANAESTHESIA: Supine. General anaesthesia.
SURGICAL TECHNIQUE: 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.
POSTOPERATIVE MANAGEMENT: Below knee plaster of Paris. Removal of K'wires after consolidation of osteotomies. Progressive increase in weight bearing. Arch supports.
POSSIBLE COMPLICATIONS: 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.
INDICATIONS: Problems with shoe wear. Aesthetic appearance. (Limitation of function.)
CONTRAINDICATIONS: None.
PREOPERATIVE WORK UP: Drawing of surgery to be performed.
POSITIONING AND ANAESTHESIA: Supine. General anaesthesia.
SURGICAL TECHNIQUE: 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.
POSTOPERATIVE MANAGEMENT: Below knee plaster of Paris. Removal of K'wires after consolidation of osteotomies. Progressive increase in weight bearing. Arch supports.
POSSIBLE COMPLICATIONS: 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.