先天性内反足に対する中足骨骨切り術の経験

Abstract

Adductional defomity of congenital club foot almost always originates in the Chopart joint, and rarely originates in the Lisfranc joint.We performed metatarsal osteotomy to treat aductional defomity in the Lisfranc joint of four patients with congenital clubfoot.We adopted the “Lowe angle” for evalution of the adductional defomity in the Lisfranc joint. Before surgery the average Lowe angle was sixty degrees and after surgery it was seventy-nine degrees. The average follow up period from the metatarsal osteotomy was seven years (range, 5-11 years) and the average Lowe angle at final follow up was ninety degrees.The operative evaluations of the four cases were all good.We have experienced a case with fatigue fractures of the fourth metatarsal bones on both feet, caused by the adductional deformity in the Lisfranc joints of congenital clubfoot. Metatarsal osteotomy needs a comparatively simple technique. We recommend this operation in order to achieve not only good foot aligrmment but also good function.