الفهرس | Only 14 pages are availabe for public view |
Abstract Although early reports on the natural history of residual forefoot adduction in clubfoot suggested that spontaneous and progressive correction would occurs,it’s now agreed that such an evolution may be expected in congenital metatarsus adductus but not in clubfoot. Several surgical procedures have been described to treat forefoot adduction. Some of them include soft tissue releases, others include many different bone surgeries to address this problem, these operations include, tarsometatarsal and intermetatarsal joints release , the closing wedge osteotomy of the cuboid and opening wedge osteotomy of the medial cuneiform (the double tarsal osteotomy operation )and excision and fusion of the calcaneocuboidjoint (Evan’s operation) One key principle involved in understanding the physiopathology of forefoot adduction states that there is an imbalance between an elongated lateral column and a shortened medial column (Evan’s 1961).Therefore, some procedures to restore the balance of the foot propose shortening of the lateral column ,whereas others defend the lengthening of the medial column ,and the remaining believes that the combination of lateral column shortening and medial column lengthening is the most logical approach in correcting this deformity. |