Schwere Fußdeformitäten im Jugend- und Erwachsenenalter — Techniken nach Imhäuser, Lelièvre und Lambrinudi

Abstract

Severe contraction deformities of the foot, e.g. after trauma or spasticity, often lead to an inability to walk and can, in part, only be rectified by corrective bone osteotomy of the hind and middle foot. In this article, we discuss hind and middle foot osteotomies in cases of severe foot deformities in adolescents and adults. The surgical techniques of Lambrinudi, Imhäuser and Lelièvre will be considered. The surgical technique of Lambrinudi uses a triple arthrodesis between the talus, calcaneus and navicular bones, and the cuboid bone, in addition to the removal of a bone wedge from the talus for correction of the talipes equinus deformity. Severe contraction talipes calvus can be straightened and capable of loading using Imhäuser's technique with wedge osteotomy and arthrodesis in Chopart's joint. The planigrade position is achieved by the removal of a dorsolaterally based wedge from Chopart's joint. Using Lelièvre technique, severe contraction club foot with hind foot varus can be treated with a wedge from Chopart's joint and the talocalcaneal joint with arthrodesis. For stabilization, a compression clamp system is used. The advantages of the system used by us is that, in comparison with other systems, it can also be used for sclerotic bones as the shank is not hammered in but is introduced after boring. Using the compression clamp system, good stability and a high rate of osseous blood circulation can be achieved using osteotomies and arthrodeses. The aim of surgery is, in all cases, the correction of the deformity, functional improvement and the elimination of pressure points and pain.