Two-stage surgical treatment for medially angulated great toes in Apert feet by wedged corrective osteotomy with distraction of the inter-metatarsal space: A case report

BACKGROUNDOne of most severe clinical problems related to Apert foot anomalies is medial angulation deformities of the great toe as the foot grows. CASE PRESENTATIONThe patient was a 22-month-old Japanese child with Apert syndrome, who had broad bilateral great toe showing medially angulated deformi...

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Bibliographic Details
Published in:Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2023
Main Authors: Iba, Kousuke, Yotsuyanagi, Takatoshi, Yamashita, Ken, Onuma, Masahiro, Kitada, Ayaka, Ueda, Naohiro
Format: Report
Language:English
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Summary:BACKGROUNDOne of most severe clinical problems related to Apert foot anomalies is medial angulation deformities of the great toe as the foot grows. CASE PRESENTATIONThe patient was a 22-month-old Japanese child with Apert syndrome, who had broad bilateral great toe showing medially angulated deformity. We performed two-stage surgical treatment including distraction of the remarkable narrowing the first inter-metatarsal space using an external distractor device, and the corrective wedge-osteotomy of the first metatarsal with a graft of wedged bone in the reverse direction and inter-positioning of the resected local bone between the first and second metatarsal to preserve the space. At 3 years after surgery, the patient did not have any disturbance of gait and could wear normal shoes without weight-bearing pain, and was satisfied with the appearance of the great toes. CONCLUSIONThe two-stage surgical method could be an option for surgical treatment of Apert feet.
ISSN:1436-2023
DOI:10.1016/j.jos.2023.07.018