Medial Cuneiform Osteotomy with Allograft Implant without Internal Fixation in Pediatric Patients: A Retrospective Study

Steven P Brancheau

Department of Podiatric Surgery, Hunt Regional Medical Center, USA

^*Correspondance to: Steven P Brancheau 

 PDF  Full Text DOI: 10.25107/2474-1647.1440

Abstract

The Cotton medial cuneiform osteotomy is a common procedure for treatment of planal deformities in the pes planus foot. Its use with an allograft application makes it a powerful procedure to help restore the medial longitudinal arch, forefoot varus or medial column instability. Though the operative technique is standard among most surgeons, the use of fixation to the allograft varies. The purpose of our study was to determine retrospectively if lack of fixation affected correction values or consolidation rates. Fifty-six pediatric cotton osteotomies and allograft implants without fixation were retrospectively viewed on radiographs to assess consolidation. The radiographs were analyzed by three different surgeons and classified by the postoperative period: immediate, 4 weeks, 8 weeks, and 12 weeks. The amount of correction was determined on a standard lateral radiograph by measuring the length of the osteotomy site using the most distal and proximal portion of the dorsal cortex of the medial cuneiform. The results were found to be excellent as 50 out of 56 (89.28%) cotton procedures displayed radiographic consolidation at post-operative week 8. Five of the remaining six went to consolidation at a later time. No metatarsal primus elevatus was identified long term suggesting that our correction was maintained. This study suggests fixation does not influence consolidation rates as adequate correction is maintained.

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Cite the article

Brancheau SP. Medial Cuneiform Osteotomy with Allograft Implant without Internal Fixation in Pediatric Patients: A Retrospective Study. Clin Surg. 2017; 2: 1440.