Features of static, paralytic and iatrogenic foot joints deformities diagnosis and treatment

Abstract

Aim. To evaluate the efficiency of treating patients with orthopedic foot diseases for previous 30 years, including treatment using high technology methods. Methods. 700 patients aged from 16 to 85 years underwent surgical treatment. All foot state parameters were scored using a 10-point grading system. To specify the transversal arch parameters, computed tomography and magnetic resonance tomography were performed. To assess the general condition of the foot, vascular ultrasound, electroneuromyography, biomechanical examination using ink print mats and podometry. In treating patients with hallux valgus in most of the cases (55%) straightening surgery of first metatarsus partial removal at proximal epiphysis was preferred. First metatarsophalangeal endoprosthesis, orhtopedic casts and various types of osteotomy for hallux valgus straightening were also used. Results. Patients had the mean total foot condition score at 31.3 points (normal range is upper than 50) indicating grade II-IV, after the surgical treatment the mean total foot condition score was 46.7 points in 91.6% of treated patients. Inappropriate staging of surgical treatment has leaded to inadequate treatment outcomes, in particular, surplus caput osteotomy of first metatarsus leaded to first metatarsophalangeal joint osteoarthritis progression and to hallux varus development. Conclusion. Appropriate pre-surgical planning and use of high technology methods of surgical treatment allows to compensate even advanced foot deformities.