[Surgical correction of flatfoot].

Area of Science:

• Orthopedic surgery
• Podiatric medicine
• Biomaterials in surgery

Background:

• Transverse platypodia and first toe outward deviation are common foot deformities.
• Existing treatments have varying success rates and recurrence patterns.

Purpose of the Study:

• To evaluate the efficacy of surgical interventions for transverse platypodia and first toe outward deviation.
• To compare outcomes between different surgical techniques and materials.

Main Methods:

• Surgical treatment of 76 patients with transverse platypodia and first toe outward deviation.
• Procedures included clinoid resection of the first metatarsus head combined with plasty of the transverse foot fornix using vascular prosthesis or lavsan bands.
• A novel method involving shifting the anterior tibial muscle tendon was used for longitudinal platypodia.

Main Results:

• No recurrences were observed in 55 patients (72.4%) treated with combined plasty and resection over 2-10 years.
• Vascular prostheses showed no bone destruction, while lavsan bands led to destruction in 8 of 22 patients within 1-2 years.
• Additional clinoid resection in 12 patients with prior surgery reduced recurrences, and the tendon shifting method yielded good functional results in 19 patients.

Conclusions:

• Combined plasty with vascular prosthesis and clinoid resection is a highly effective treatment for transverse platypodia and first toe deviation, with no recurrences or bone destruction.
• Lavsan bands may lead to complications, and additional clinoid resection can address recurrences.
• The anterior tibial tendon shifting technique offers a good functional outcome for longitudinal platypodia.