Cahuzac's procedure for club foot revision surgery

Purpose of the study The authors report 24 cases of revision in recurrent club foot deformity. T hey assessed Cahuzac's procedure for treatment of the residual forefoot add uction, This procedure (opening of the first cuneo-metatarsal joint and pro ximal abduction osteotomy of the second, third, and fourth metatarsals) was generally associated with postero-medial, plantar release, and split tibia lis anterior tendon transfer. Material Twenty four procedures for 20 children at mean age of five years have been performed. The revision chart comprised 12 clinical and radiological items as proposed by Seringe. Results Seven feet were considered as excellent, 14 as good, 2 as fair, and 1 as po or, The mean follow-up was four years. Discussion Treatment of the adduction component with Cahuzac procedure is focused on t he fore part of the foot, and on the calcaneo-pedal block by postero medial release, but never on the midfoot, as no Evans or Lichtblau's procedure ha s been performed. This series was compared to others procedures, and morpho logical results were equivalent. Cahuzac's operation is riskless for foot g rowth, and needs two approaches which can be useful for simultaneous proced ures as split lateral transfer of tibialis anterior tendon. Conclusion Metatarsal osteotomies (Cahuzac's procedure), associated with soft tissues release and split anterior tibial transfer, seems to be effective in surgic al treament of relapsed clubfeet, but the debate concerning the location of the adduction component of the deformity remains still open.