Tarsal abductory osteotomy in the treatment of residual adduction deformity after clubfoot surgery

Adduction of the forefoot is the most common deformity after clubfoot surgery. Surgical correction is often required for the moderate and severe deformities. Deformity correction at its apex provides the best correction with no translational deformity. Tarsal bones osteotomy should allow good healing with less stiffness of the foot than metatarsal base osteotomy. The present study included 18 patients. In 14 patients the deformity was bilateral and it was unilateral in the other four with a total of 32 feet. The youngest patient at the time of surgery was four years and the oldest was ten years. The procedure included osteotomy of the cuboid and the third and second cuneiforms, a closing wedge of the cuboid bone was removed and used for an opening wedge of the medial cuneiform. Fixation was achieved by Kirschner wires or staples and below knee cast. Clinical and radiological improvement of deformity was achieved in all patients and no complications were seen. Lesser tarsal abductory osteotomy allows deformity correction at its apex, little technical difficulty and better osteotomy healing