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Helal Metatarsal Osteotomy in Apert Foot
Ilaria Casula1, Stéphane Guero1,2
1Institut de la Main, Clinique Bizet.
Journal of Pediatric Orthopedics
|August 18, 2020
Summary
The Helal metatarsal osteotomy effectively treats painful plantar subluxation in Apert syndrome feet, allowing patients to walk comfortably in normal shoes after surgery. This safe technique corrects metatarsal deformities without complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Craniomaxillofacial Surgery
Background:
- Apert syndrome causes craniosynostosis and complex hand/foot malformations.
- Plantar subluxation of the metatarsal head is a common, painful complication in Apert syndrome.
- This condition leads to walking impairment due to pressure, hyperkeratosis, and pain.
Purpose of the Study:
- To evaluate the effectiveness of the Helal metatarsal osteotomy for treating plantar metatarsal head subluxation in Apert syndrome.
- To describe the surgical technique and patient outcomes.
Main Methods:
- The Helal metatarsal osteotomy technique was applied to 17 feet in 12 Apert syndrome patients.
- Osteotomies were performed on one to three metatarsal bones per foot.
- A hypercorrective bandage was used post-operatively, with immediate full weight-bearing encouraged.
Main Results:
- No infections or delayed wound healing occurred.
- Radiographs confirmed complete bone consolidation within 3 weeks.
- Patients experienced reduced pressure and pain, enabling them to wear normal shoes.
Conclusions:
- The Helal metatarsal osteotomy is a safe, reproducible, and feasible surgical option.
- It effectively addresses painful metatarsal head plantar subluxation in Apert syndrome feet.
- This technique should be considered for managing this specific complication.
