Treatment of Calcaneal Fracture Malunion Using Lateral Exostectomy and Corrective Osteotomy: A Report of Three Cases / 대한족부족관절학회지

Inappropriate treatment for calcaneus fracture may result in malunion causing long-lasting pain and functional deficits. When such complications occur, the ideal principle of management is preserving congruence and motion of adjacent joints. For three patients with calcaneus fracture malunion, subtalar joint-preserving surgery using exostectomy and corrective osteotomy was performed, and satisfactory outcomes were achieved postoperatively.

Treatment of Bunionette Deformity with Diaphyseal Oblique Osteotomy / 대한족부족관절학회지

PURPOSE: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. MATERIALS AND METHODS: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. RESULTS: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from 12.7degrees to 3.1degrees and the fifth metatarsophalangeal angle improved from 16.6degrees to 2.3degrees. CONCLUSION: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.

Bunionette Deformity / 대한족부족관절학회지

The bunionette, or a 'tailor's bunion', is a lateral bony prominence of the fifth metatarsal head. A bony deformity itself rarely causes symptom but if a painful inflammation of the overlying soft tissue is accompanied, it needs treatment. Conservative care using a shoe modification, padding, or orthosis is effective in most cases. Surgical management is indicated when the conservative methods have failed to improve symptoms, and the techniques include exostectomy, metatarsal osteotomies (distal, diaphyseal, or proximal), metatarsal head resection or fifth ray resection. We reviewed the etiology, clinical features, radiographic classification, nonoperative and operative treatments of the bunionette.