results of U- shaped calcaneo-talar osteotomy in correction of hindfoot deformities

ABSTRACT

Thirty patients; 21 males [70%] and 9 females [30%] with an average age of 24 years old had had hindfoot deformities due to old poliomyelitis in 24 cases [80%] and neglected T.E.V in 6 cases [20%] and subjected to a calcaneotalar osteotomy. The presenting hindfoot deformities included equinovarus in 22 cases [73.33%]; equinovalgus in 2 cases [6.66%], ealcaneus in 4 cases [13.33%] and calcaneovalgus in 2 cases [6.66%]. Associated mid and forefoot deformities included cavovarus in 22 cases [73.3 3%]; calcaneovalgus in 2 cases [6-66%] and forefoot valgus in 2 cases [6.66%] and clawing of toes in 18 cases [60%]. Unstable ankle was present in 3 cases [10%]. Previous 42 operations had been done at an average period of 16 years before. The ostcotomy describes a roughly semicircular cut from just posterior to the talocalcanean joint, downwards in the calcaneus and upwards and forward into and through the talar head. Postoperative cast fixation was done in 3 cases [10%] and Ilizarov external fixator was used in 27 cases [90%]. Additional operations were done to corea the mid and hind foot and toe deformities and to stabilize the unstable ankle either at the first operation or at 2 and 4 weeks interval from the first operation. The average postoperative fixation was 3 months in the cast and 5 months in the fram. No major complications were happened The average follow - up period was 3 year. The mean time for osteotomy site to unite was 21/2 months. The subjective results were excellent in 18 cases [60%]; good in 9 cases [30%] and poor in 3 cases [10%]. Objectively, the results were excellent in 24 cases [80%] and good in 6 cases [20%]