Treatment of severe residual clubfoot deformity by trans-midtarsal osteotomy

This study reviews the preliminary results of transmidtarsal osteotomy perf ormed on 11 patients (12 feet) who previously underwent surgery for resista nt clubfoot and needed further surgery for severe residual deformities. Ope ning wedge medial cuneiform osteotomy, closing wedge cuboid osteotomy, and truncated wedge middle and lateral cuneiform osteotomy were performed. The procedure was performed initially on normal cadaver feet. The average impro vement of anteroposterior tale-first metatarsal angle was 20 degrees and la teral calcaneo-first metatarsal angle was 16 degrees. The authors conclude that with this simple procedure, angular and rotational correction in three planes can be obtained simultaneously in severe residual clubfoot deformit y without the need for extensive soft tissue release.