The Journal of Bone and Joint Surgery, Vol 75, Issue 2 190-195, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
Deformity of the calcaneocuboid joint in patients who have talipes equinovarus
JG Thometz and GW Simons
Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee 53226.
A retrospective analysis was done of the records and radiographs of 100
club feet (in sixty-six patients) that had been consecutively treated with
an operation. Twenty-six feet (26 per cent) had had a Grade-II deformity of
the calcaneocuboid joint, as determined with a radiographic classification
that had been developed on the basis of the degree of medial displacement
of the cuboid. When the calcaneocuboid joint is in normal alignment, the
central point of the cuboid ossification center lies on the
mid-longitudinal axis of the calcaneus; when there is a Grade-I deformity,
the mid-point of the cuboid ossification center lies lateral to the medial
tangent but medial to the longitudinal axis of the calcaneus; and when
there is a Grade-II deformity, the central point of the cuboid lies on or
medial to the medial tangent of the calcaneus. Although a Grade-I deformity
of the calcaneocuboid joint need not be corrected, a Grade-II deformity
should be treated with release of the calcaneocuboid joint, which in this
series was performed in conjunction with a complete subtalar release
(including a talonavicular release). Sixteen of the twenty-six feet that
had a Grade-II deformity had a complete release of the calcaneocuboid joint
at the time of the operation; the release was not done in the remaining ten
feet, some of which were operated on early in the series, before the
importance of the deformity at the calcaneocuboid joint had been
recognized.(ABSTRACT TRUNCATED AT 250 WORDS)