Biplane cuneiform osteotomy for juvenile metatarsus primus varus

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Foot and Ankle Surgery

Background:

• Juvenile metatarsus primus varus is a complex foot deformity.
• Existing surgical methods have limitations in addressing associated biomechanical issues.
• Correction requires addressing both sagittal and transverse plane deformities.

Purpose of the Study:

• To present a novel surgical approach combining Cotton and Fowler procedures for juvenile metatarsus primus varus.
• To evaluate the efficacy of this combined technique in correcting foot deformities.

Main Methods:

• A biplanar opening wedge osteotomy of the medial cuneiform with bone grafting and internal fixation.
• Integration of the Hohmann osteotomy/bunionectomy for hallux valgus correction.
• Surgical technique evolves from established Cotton and Fowler procedures.

Main Results:

• Excellent reduction of the intermetatarsal angle achieved.
• Successful realignment of the oblique metatarsal-cuneiform joint.
• Effective correction of associated hallux valgus.

Conclusions:

• The combined Cotton-Fowler procedure offers a viable solution for juvenile metatarsus primus varus.
• This technique provides significant biomechanical correction and addresses associated deformities.
• The procedure demonstrates excellent outcomes in clinical application.