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Journal of Bone and Joint Surgery, 1971;53:498-506.
© 1971 by The Journal of Bone and Joint Surgery, Inc

Metatarsal Osteotomy for the Correction of Adduction of the Fore Part of the Foot in Children

ARNOLD BERMAN M.D.1 and JOHN J. GARTLAND M.D.1

1 From the Pennsylvania State Hospital for Crippled Children, Elizabethtown

1. Metatarsal osteotomy is a satisfactory method of correcting persisting fixed adduction of the fore part of the foot, regardless of cause, in a child six years old or older.

2. Intramedullary fixation by a Steinmann pin in the first and fifth metatarsals combined with a below-the-knee plaster cast maintained for six weeks is the preferred form of postoperative immobilization.

3. Metatarsal osteotomy in forty-four feet operated on because of resistant adduction of the fore part of the foot after treatment for congenital club foot produced thirty-seven good or excellent results. Metatarsal osteotomy in eighteen feet operated on because of recurrent or resistant metatarsus adductus produced seventeen good or excellent results. Metatarsal osteotomy in fifty-three feet operated on to correct resistant adduction of the fore part of the foot in patients with poliomyelitis, cerebral palsy, idiopathic cavoadductus, myelodysplasia, and a group of miscellaneous causes produced forty-three good or excellent results.

4. Metatarsal osteotomy can be combined with other surgical procedures as a two-stage procedure designed to correct either valgus or varus deformity of the hind part of the foot. Such procedures as the Grice extra-articular subtalar bone graft, the Dwyer calcaneal osteotomy, or triple arthrodesis may precede or follow the metatarsal osteotomy.


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