Combined cuboid/cuneiform osteotomy for correction of residual adductus deformity in idiopathic and secondary club feet

We used a combined cuboid/cuneiform osteotomy to treat residual adductus de formity in idiopathic and secondary club feet. The mean follow-up for 27 fe et (22 idiopathic, four arthrogrypotic and one related to amniotic band syn drome) was 5.0 years (2.0 to 9.8). All healed uneventfully except for one e arly wound infection. No further surgery was required in the 22 idiopathic club feet but four of five with secondary deformity needed further surgery. At follow-up all patients with idiopathic and two with secondary club feet mere free from pain and satisfied with the result, In the idiopathic feet, adductus of the forefoot, as measured by the calcaneal second metatarsal a ngle, improved on average from 20.7 +/- 2.0 degrees to 8.9 +/- 1.8 degrees (p < 0.05). In four feet, with a follow-up of more than six years, there wa s complete recurrence of the deformity, In the secondary club feet, there w as no improvement of the adductus, We conclude that in most, but not all, i diopathic club feet a cuboid/cuneiform osteotomy can provide satisfactory c orrection of adductus deformity. Those,vith secondary deformity require oth er procedures.