Wedge tarsectomy using patient specific instrumentation for complex multiplanar foot deformity Reconstruction: A...

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction
• Biomechanical correction

Background:

• Complex cavovarus foot deformities often require multiplanar bony correction.
• Wedge tarsectomy (WT) is a surgical technique used for correction.
• Patient-specific instrumentation (PSI) may enhance surgical accuracy.

Purpose of the Study:

• To evaluate the outcomes of wedge tarsectomy (WT) guided by patient-specific instrumentation (PSI) for complex cavovarus deformities.
• To assess the accuracy of PSI plans and guides in achieving multiplanar bony correction.
• To analyze radiological and patient-reported outcome measures (PROMs) following PSI-guided WT.

Main Methods:

• Prospective case series at a single center.
• Inclusion of patients with noncorrectable cavovarus feet undergoing PSI-guided WT.
• Recording of PSI accuracy, operative duration, and adjunctive procedures.
• Collection of weightbearing CT (WBCT) measurements and PROMs preoperatively and postoperatively.
• 1-year follow-up and statistical analysis of collected data.

Main Results:

• Eleven patients were included in the study.
• Planned multiplanar correction was achieved with minor intraoperative adjustments in two cases.
• Nine patients required adjunctive procedures.
• Mean operative time was 135 minutes.
• Significant radiological improvements and enhanced MOxFW walking distance were observed postoperatively.
• All patients achieved fusion within 3 months with no major complications.

Conclusions:

• PSI-guided wedge tarsectomy provides a safe and predictable method for achieving multiplanar correction in complex cavovarus foot deformities.
• The technique demonstrated excellent clinical outcomes in this series, particularly for larger deformities.
• Improvements in patient walking ability were noted, supporting the efficacy of PSI-guided WT.