Authors
Apresyan V.S.1, Makinyan L.G.1, Mannanov A.M.1, Samkovich D.A.1, Podlesnaya A.A.2
1 RUDN University, Moscow
2 I.M. Sechenov First Moscow State Medical University, Moscow
Abstract
Rationale: Cole osteotomy is performed in patients having a cavus deformity with the apex of the deformity in a plantigrade foot. We invented a new approach in cavus foot surgery: removing the navicular bone and wedge-shaped osteotomy of the cuboid bone. We retrospectively reviewed and compared the clinical and radiographic results of 16 feet (16 patients) that underwent Cole midfoot osteotomy, and 11 feet (11 patients) that underwent removing of the navicular bone ande midfoot. Correction of the deformity at this midfoot level improves foot and ankle stability by creatin wedge-shaped osteotomy of the cuboid bone (2020–2023).
Objective: to compare clinical results of two methods of surgical treatment of the cavus foot: removal of the navicular bone with osteotomy of the cuboid bone and osteotomy of Cole.
Methods: The patients had two etiologies (idiopathic pes cavus and Charcot-Marie-Tooth disease). In the first group dorsal and slightly laterally based transverse wedge osteotomy through the navicular bone medially and the cuboid bone laterally was performed, in the second group — removal of the navicular bone and wedge-shaped osteotomy of the cuboid bone. Patients were under routine clinical follow-up. We evaluated clinical and radiographic results.
Results: Mean clinical follow-up was 15.7 months (range, 6–36 months). The mean preoperative and postoperative talo–first metatarsal angles on lateral radiographs were 29,9 and 8,7, respectively (р<0,05) after the Cole osteotomy and 27,2 and 5,4, respectively (P , .05) after the navicular bone removal. The mean postoperative calcaneal pitch angle changes were 10,8 on the lateral radiograph (р<0,05) after the Cole osteotomy and 15,6 after the navicular bone removal (р<0,05). At final follow-up, all patients were independently active, had plantigrade feet,and were able to wear conventional shoes. The mean American Orthopaedic Foot and Ankle Society questionnaire score was 38.8 preoperatively and 79.5 postoperatively (р<0,05) in the first group and 37,4 preoperatively and 83,5 postoperatively р<0,05) in the second group. One patient after the Cole osteotomy did not have full bony union.
Conclusions: removing the navicular bone and wedge-shaped osteotomy of the cuboid bone is a safe procedure to correct adult pes cavus deformity with the apex in midfoot, and has similar results as Cole osteotomy.
Keywords: cavus foot, prevention of cavus feet, correction of cavus foot.
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