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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Distraction osteogenesis for complex foot deformities: U-osteotomy with external fixation.
Monique C Gourdine-Shaw1, Bradley M Lamm, Dror Paley
1Department of Podiatry, Medical Service Corps, United States Navy, National Naval Medical Center, Bethesda, MD 20889-5600, USA.
The Journal of Bone and Joint Surgery. American Volume
|August 3, 2012
Summary
This study shows that U-osteotomy with external fixation effectively corrects complex foot deformities, achieving a plantigrade foot in all patients. This surgical technique offers a viable solution for challenging foot malalignments.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Reconstruction
- Skeletal Deformity Correction
Background:
- Complex foot deformities often require surgical intervention.
- U-osteotomy is indicated for specific deformities with pre-existing joint stiffness or fusion.
- The goal is to achieve a plantigrade foot and potentially increase foot height.
Purpose of the Study:
- To evaluate the efficacy of U-osteotomy with gradual correction using external fixation for complex multiplanar foot deformities.
- To assess clinical and radiographic outcomes in patients undergoing this procedure.
Main Methods:
- Fifteen patients with complex foot deformities (congenital, traumatic, developmental) underwent U-osteotomy and gradual correction with external fixation.
- The mean age was 20 years, with a mean external fixation duration of 5 months.
- Follow-up averaged 5 years, with clinical and radiographic assessments.
Main Results:
- All 15 patients achieved osseous union and a plantigrade foot.
- Significant radiographic changes included calcaneotibial angle correction (18° valgus), posterior calcaneal translation (-8 mm), and foot height increase (20 mm).
- Four patients experienced seven complications; 14 patients could walk without assistance.
Conclusions:
- U-osteotomy combined with gradual external fixation is a successful method for correcting complex foot deformities.
- This technique reliably restores a plantigrade foot in patients with multiplanar malalignments.
- The procedure demonstrates significant radiographic correction and functional improvement.
