Percutaneous Correction of Persistent Severe Metatarsus Adductus in Children

Knörr, Jorge; Soldado, Francisco; Pham, Thuy Trang; Torres, Ana; Cahuzac, Jean-Philippe; Gauzy, Jérôme Sales de

doi:10.1097/bpo.0000000000000122

Cited by 26 publications

(20 citation statements)

References 14 publications

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“…It is difficult to evaluate metatarsus adductus in the pediatric age due to insufficient ossification centers of the navicular, cuboid and cuneiform bones (8). Therefore, it is recommended to use TM 1 angle and M 4 M angle on radiographs to evaluate metatarsus deformity in children (5,8). For this reason, unlike the study of Farsetti et al (2), we evaluated different radiological measurements assessing the metatarsus adductus deformity in our study.…”

Section: Discussionmentioning

confidence: 96%

“…The results of the TATT procedure in the treatment of relapsed clubfoot have been investigated in various studies (2,5,6). The TATT procedure primarily improves dynamic supination gait by providing muscle balance (7).…”

Section: Discussionmentioning

confidence: 99%

“…Metatarsus adductus deformity in relapsed clubfoot are also treated by osteotomies of metatarsal, cuneiform and cuboid bones (5,9,10). But these procedures may have serious complications as delayed wound healing, malunion, nonunion and shortening of the metatarsal (11).…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot

Özyalvaç¹,

Kirat²,

Akpınar³

et al. 2019

Istanbul Med J

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Amaç: Pes ekinovarus (PEV) sekellerine ve nükslerine bağlı ayağın dinamik süpinasyonun tedavisinde tibialis anterior tendon transferi (TATT) oldukça sık uygulanan bir tedavi yöntemidir. Bu yöntemde TAT'nin insersyosu ayak medialinden orta hatta taşınmaktadır. Dolayısı ile tibialis anteior kasının ayak ortasını medialden laterale doğru iterek metatarsus adduktus deformitesini düzeltici yönde etki gösteren bir kuvvet vektörü oluşmaktadır. Ancak TATT'nin PEV'in komponentlerinden biri olan metatarsus adduktus deformitesi üzerine olan etkisi hakkında yeterli literatür bilgisi bulunmamaktadır. Çalışmamızın amacı TATT'nin metatarsus adduktus deformitesi üzerine olan etkisini araştırmaktır. Yöntemler: Kliniğimiz dijital arşivinden faydalanılarak 2007-2015 yılları arasında PEV tanısı ile TATT yapılan 11 hastanın 16 ayağı çalışmaya dahil edildi. Hastaların basarak çekilmiş olan ayak anteroposterior grafileri üzerinden operasyon öncesi ve sonrası talus-1. metatars açısı, talokalkaneal açı ve 4. metatars metafizyel açı ölçümler yapılararak metatarsus adduktus deformitesinin düzelme miktarı istatiksel olarak değerlendirildi. Bulgular: Ortalama 26±15 aylık takip sonrası tendon transferi cerrahisinden sonra talus-1. metatars açısı 18,8±1 dereceden 10,9±6 18,8±1 dereceye, talokalkaneal açı 22,5±8,6 dereceden 24,4±9,3 deceye, 4. metatars-metafizial açı ise 38±14 dereceden 27±11 dereceye geriledi. Talus-1. metatars açısı ve 4. metatars-metafizial açıda istatiktiksel olarak anlamlı radyolojik düzeltme gözlemlenirken (p<0,05), talokalkaneal açıda istatistiksel olarak anlamlı değişiklik gözlenmedi (p=0,51). Sonuç: PEV'li çocuklarda TATT, metatarsus adduktus deformitesinde radyolojik düzelme sağlamaktadır. Bunun nedeni, PEV'de TAT'nin ayakta dorsifleksor/evertor olarak değil invertör olarak çalışmaya başlaması olarak düşünülebilir. Sonuç olarak TATT uygulanan hastalarda metatarsus adduktus deformitesi için ek cerrahi uygulaması gerekliliği yeniden gözden geçirilmelidir. Anahtar Kelimeler: Çarpık ayak, metatarsus adduktus, pes ekinovarus, tibialis anterior tendon transferi Introduction: Tibialis anterior tendon transfer (TATT) is a common treatment method used in the dynamic supination of the foot due to sequelae or relapse of pes equinovarus (PEV). In this method, the TAT is transferred from its insertion on the medial cuneiform to the lateral cuneiform. Therefore, TATT surgery may have a corrective effect on metatarsus adducus deformity by creating a force vector that pushes the middle of the foot from medial to lateral. However, there is limited literature on the effect of TATT on metatarsus adductus deformity, which is one of the components of clubfoot. The aim of our study was to investigate the effect of TATT on metatarsus adductus deformity. Methods: Sixteen feet of 11 patients who underwent TATT with the diagnosis of PEV between 2007-2015 were included in the study. Pre-and postoperative talus-1.metatarsal angle, talocalcaneal angle and 4. metatars-metaphyseal angle were measured on standing antero-posterior radiographs. The co...

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot

Özyalvaç¹,

Kirat²,

Akpınar³

et al. 2019

Istanbul Med J

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“…Serial casting may be suffi cient, with more invasive interventions reserved for severe or late-presenting cases. Minimally invasive, percutaneous surgical techniques are effective in treating the adduction deformity refractory to casting [ 79 ].…”

Section: Metatarsus Adductus (Box 156)mentioning

confidence: 99%

The Foot and Ankle: Congenital and Developmental Conditions

Hammer

Pai

2014

Pediatric Orthopedic Imaging

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The radiographic evaluation of congenital and developmental abnormalities of the foot and ankle provides critical information to guide orthopedic treatment. This chapter begins by discussing the anatomy and normal variants of the ankle. Congenital and developmental abnormalities of the ankle are explored, including ball-and-socket ankle. The development and normal variants of the pediatric foot are then discussed. After describing radiographic techniques for imaging the foot, the chapter presents methods to evaluate and vocabulary to describe foot alignment. This is then applied to a broad spectrum of structural deformities of the foot, including clubfoot, cavus deformity, and multiple types of fl atfoot (including tarsal coalition). A discussion of forefoot alignment follows, and the chapter concludes with a brief discussion of congenital foot malformations.In order to provide useful interpretations of foot and ankle radiographs, the radiologist must have a thorough knowledge of the many normal variants that affect this area, recognizing those that may mimic or obscure pathology. Analysis of alignment requires a careful, systematic approach, along with a clear understanding of normal alignment, the wide variety of possible deformities, and the many ways they may combine to create unique constellations of pathology.

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“…[17,18] Knörr ve arkadaşla-rı, yakın zamanda yaptıkları çalışmalarında, perkütan olarak 2-3-4-5 metatars proksimallerine osteotomi ve 1. metatarso-küboid ekleme redükte pozisyonda K-teli ile uyguladıkları Cahuzac tekniği ile, 34 ayakta mükem-mel sonuç bildirmişlerdir. [19] Cerrahi teknik olarak bakıldığında; ağır veya sert MA'lı olgularda osteotomi yapılması görüşü günümüz-de kabul görmüştür. Osteotomi lokalizasyonu konusunda farklı görüşler halen mevcuttur.…”

Section: Gözlemlemekunclassified

Metatarsus adduktus

Günay¹

2017

TOTBID

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Percutaneous Correction of Persistent Severe Metatarsus Adductus in Children

Abstract: Level II.

Cited by 26 publications

References 14 publications

The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot

The Effect of Tibialis Anterior Tendon Transfer on Metatarsus Adductus Deformity in Children with Clubfoot

The Foot and Ankle: Congenital and Developmental Conditions

Metatarsus adduktus

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