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Realignment Midfoot Osteotomy: A Preoperative Planning Method and Intraoperative Surgical Technique.

Matthew Hentges1, Emily Pugh2, Martin G Gesheff3

  • 1Fellowship Trained Foot & Ankle Surgeon, Faculty, Foot and Ankle Surgery Residency Program, Allegheny Health Network, West Penn Hospital, Pittsburgh, PA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|July 14, 2021
PubMed
Summary

This study introduces a new planning method for midfoot osteotomies to correct foot deformities. The technique achieved significant improvements in radiographic alignment and good clinical outcomes.

Keywords:
CORACharcotaxiscavusclubfootdeformity correctionmultiplanarpes planus

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Area of Science:

  • Orthopedic surgery
  • Foot and ankle reconstruction
  • Surgical planning

Background:

  • Midfoot osteotomies are common procedures for correcting foot deformities.
  • Achieving a plantigrade forefoot to hindfoot relationship is the primary goal.
  • Existing techniques for midfoot osteotomies vary, highlighting the need for standardized methods.

Purpose of the Study:

  • To present an objective pre-operative planning method for midfoot osteotomies.
  • To describe an intra-operative technique for accurate multiplanar realignment.
  • To discuss the short-term clinical results of this novel approach.

Main Methods:

  • Retrospective review of 18 patients (10 female, 8 male) who underwent realignment midfoot osteotomies.
  • Utilized a specific pre-operative planning and intra-operative technique for multiplanar realignment.
  • Mean follow-up of 25 months; mean patient age at surgery was 53 years.

Main Results:

  • Statistically significant improvement in the anteroposterior talo-first metatarsal angle (p = .002).
  • Significant improvement in the mechanical axis deviation of the foot (p = .02).
  • Demonstrated accurate multiplanar radiographic realignment.

Conclusions:

  • The presented pre-operative and intra-operative planning technique enables accurate multiplanar radiographic realignment of the midfoot.
  • This method leads to good clinical results in patients undergoing midfoot osteotomies.
  • The study validates a reproducible approach for correcting midfoot deformities.