Comparison of medial cuboid/cuneiform osteotomy technique with medial cuneiform/metatarsal osteotomy in correction of residual metatarsus adductus deformity

Abstract

Abstract Background: Treatment of metatarsus adductus (MA) is surgical in cases of nonresponse to non-operative treatment. Several surgical procedures have been described to correct MA, including soft tissue release or bone osteotomy. So far in the previous literature, the preference of any other osteotomy has not been done Therefore, our aim in this study was to evaluate the extent of foot fore deformity by osteotomy based on radiographic criteria. Patients and Methods: This was a retrospective study from July 2019 to July 2020, which included 22 patients (30 feet), ranging in age from 5 to 14 years, who were admitted with a diagnosis of MT and underwent corrective osteotomy. Radiographs of deformity corrections in the AP view (tarso-first metatarsal angle –calcane-second metatarsal angle -cuboid length and the laterah view ,medial cunieform length an, length of cuboid and medial length of cunieform were examined. Results: Thirty patients (40 feet) were diagnosed with MA deformity. A total of 22 patients (30 feet) underwent corrective osteotomy. The mean age of patients in the first group was 8.87±3.56 years (means: 3-14 years) and the second group was 8±2.46 years (means: 13-13 years). In terms of sex distribution, eight patients were female and 14 patients were male. surgery has improved the angles and length of the medial and lateral columns in control radiographs after surgery and three months later,in both group and the adductus deformity has been significantly corrected (p<0.05). However, both types of osteotomies had acceptable deformity improvement results within 3 months in terms of radiographic criteria, but there is no statistically significant difference (P >0.05) between preoperative and postoperative and three months of follow-up in radiographic parameters of the two groups and only this amount was significant in medial cunieform length correction in lateral radiograph and statistically Was significant. (P<0.05). There is no statistical difference in terms of changes in values in terms of angle and length in the two osteotomy methods (P>0.05). Conclusion: Due to complete deformity corrections and high patient satisfaction in both groups, none of the conventional osteotomy methods (cuboid-medial cunieform and medial cunieform-metatarsal 2-5) was superior to the other and both methods were safe. It is effective for cases of idiopathic idiopathic MA and clubfoot cases. Level of evidence: IV