Osteotomy in the pediatric foot.

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Foot and ankle surgery

Background:

• Foot deformities are common in pediatric patients (ages 5 to skeletal maturity).
• Treatment often involves osteotomies, a primary surgical technique.
• Deformities can present in multiple planes (frontal, sagittal, transverse) and affect various foot/ankle regions.

Purpose of the Study:

• To emphasize the importance of comprehensive biomechanical assessment in pediatric foot deformities.
• To highlight the need for a cohesive treatment plan addressing all deformity aspects.
• To advocate for single-stage surgical correction when feasible.

Main Methods:

• Detailed biomechanical evaluation of the foot and ankle.
• Assessment of deformities in frontal, sagittal, and transverse planes.
• Identification of bony and non-bony (e.g., gastrocnemius contracture) etiologies.

Main Results:

• Biomechanical assessment enables detailed evaluation of multiplanar deformities.
• It facilitates understanding the interrelationship between ankle, hindfoot, midfoot, and forefoot issues.
• Recognizes that deformities are not exclusively bony, with soft tissue contractures being significant.

Conclusions:

• A thorough biomechanical assessment is crucial for effective treatment planning of pediatric foot deformities.
• Integrated treatment plans addressing all deformity components are essential.
• Surgical correction of all deformity aspects in a single operative session is the preferred approach when possible.