Effect of calcaneocuboid arthrodesis on kinematics of foot: a cadaveric study / 中国矫形外科杂志

[Objective]To discuss the effect of the calcaneocuboid arthrodesis on kinematics of foot and its clinical signifi-cance.[Method]In 10 fresh-frozen foot specimens,limitation dorsiflexion, plantoflexion, abduction, adduction , eversion, inver-sion motion of foot were determined before and after calcaneocuboid arthrodesis under non-weight with moment of couple, bendingmoment, equilibrium dynamic loading.[Result]A significant decrease in the motion of foot was observed (P

Analysis of the Calcaneocuboid Joint Involvement in Intraarticular Calcaneal Fractures / 대한족부족관절학회지

PURPOSE: This study was performed to analyze the characteristics of calcaneocuboid joint involvement in intraarticular calcaneal fractures. MATERIALS AND METHODS: Total number of 92 patients (111 cases) who underwent operation for intraarticular calcaneal fractures between Jan. 2000 and Oct. 2005 were included in this study. The preoperative computed tomographs of the subjects were retrospectively reviewed to analyze calcaneocuboid joint involvement. RESULTS: It was revealed that 63 cases (56.8%) involved calcaneocuboid joint; 29cases (46.0%) showed type 1 (undisplaced or minimally displaced type, articular gap or =2 mm), 7 cases (11.1%) were included in type 3 (comminuted type) and 11 cases (17.5%) belonged to type 4 (fracture and dislocation). 48 out of 63 cases belonged to Sanders classification II and III that involved calcaneocuboid joint and included 25 cases (52.1%) of type 1 and 14 cases (29.2%) of type 2. Among 15 out of 63 cases included in Sanders classification IV, 4 (26.7%) showed type 1 and 6 (40.0%) belonged to type 4. According to our results, Sanders classification allowed to predict pattern of the involvement of calcaneocuboid joint (P0.05). CONCLUSION: Calcaneocuboid joint involvement in intraarticular calcaneal fractures was common and more than half showed severe injuries. We concluded that further studies on the involvement of calcaneocuboid joint should be performed prior to surgical treatment of intraarticular calcaneal fractures.

Correlation between Subluxation of Calcaneocuboid Joint and Residual Forefoot Adduction in Congenital Clubfoot / 대한정형외과학회잡지

Residual adduction of the forefoot is recognized as common sequelae of treated clubfoot. The causes of residual forefoot adduction may be metatarsus varus, talonavicular subluxation and subluxation of the calcaneocuboid joint. But, less attention has been given to subluxation of the calcaneocuboid joint. The purpose of this study was to assess the correlation between subluxation of calcaneocuboid joint and residual forefoot adduction, and to suggest the guideline of treatment for subluxation of the calcaneocuboid joint. A retrospective analysis was done by the medical records and radiographs of 48 clubfeet (thirty-four patients) that had been treated with an operation (thirty-three feet) or conservative methods (fifteen feet) at the Kang-Nam St. Mary's Hospital, between 1990 and 1995. The severity of adduction of the forefoot was determined by the angle of talo-first metatarsal. Subluxation of the calcaneocuboid joint was measured by using a grading system. And then, the forefoot adduction was categorized to mild, moderate, and severe degree according to the talo-first metatarsal angle. The average length of follow-up was eighteen months. Of the 48 feet, seventeen had no subluxation of the calcaneocuboid joint (35.4%), twenty-seven Grade I subluxation (56.3%), and four Grade 3 subluxation (8.3%) on initial radiograph. On the final radiograph, twenty-five feet had a residual adduction of the forefoot. In reviewing the distribution of the residual forefoot adduction according to the initial grade of the calcaneocuboid joint subluxation, Grade 0 subluxation had 6 forefoot adduction (35.3%), Grade I subluxation had 15 forefoot adduction (55.6%), and Grade 3 subluxation had 4 forefoot adduction (100%). Grade II calcaneocuboid joint subluxation had two severe residual forefoot adduction deformities (2 out of 4 cases) and Grade I calcaneocuboid joint subluxation had one severe residual forefoot adduction deformity (1 out of 15 cases). But, there was no severe forefoot adduction deformity in Grade 0 calcaneocuboid joint subluxation. The average angle of talo-first metatarsal was decreased in Grade 0 and Grade I subluxation, whereas it was increased in Grade II subluxation. Conclusively, we believe that there is significant correlation between the severity of subluxation of calcaneocuboid joint and residual forefoot adduction, and that the patients who have a Grade II subluxation of calcaneocuboid joint need operative correction of the subluxation of the calcaneocuboid joint.

The Operative Treatment of the Resistant clubfoot: Comparative study between modified Turco's Operation and combining calcaneocuboid release / 대한정형외과학회잡지

The 17 patients with 22 resistant clubfeet were treated with modified Turco's operation with or without combining release of calcaneocuboid joint at Department of Orthopaedic Surgery, Hanyang University School of Medicine between 1896 and 1991. They were analysed preoperatively and postoperatively with chinical and radiological methods. In patients who were treated with combined procedures, the latetal talocalcaneal angle and anteroposterior talo-first metatarsal angle in radiological findings were showed better improvement(p < 0.05), and anteroposterior talocalcaneal angle was also showed better improvement but not significant statistically, than those who were treated with modified Turco's operation alone. The final results of combined procedures were better than that of modified Turco's operation. And the most common characteristic physical findings in resistant clubfoot were small heel, deep longitudinal crease on the medial aspect of midfoot area and a single transverse crease on the posterior heel just proximal to the insertion of the tendocalcaneus. So we suggest these physical findings may be expectance for the resistance of the congenital clubfoot to conservative treatment, but it need further comparative study.