Results of biplanar chevron osteotomy performed on patients with mild-to-moderate hallux valgus deformity with an increased distal metatarsal articular angle (DMAA) are shown. The study included clinical data of 32 patients (54 feet) who had completed a 2-year follow-up, and radiological data of these 32 and other 29 patients (50 feet) for a total of 61 patients (104 feet, 53 right and 51 left). There were 59 females and two males with ages varying from 11 to 66 years. According to the AOFAS Hallux Rating, the preoperative average score (50) improved to 90 (average score after the surgery). The hallux valgus angle was improved from an average of 25 degrees to 14 degrees, the first intermetatarsal angle from 12 degrees to 8 degrees and the DMAA from 15 degrees to 5 degrees. At the end of treatment, 94% of patients were classified as having grade 0 or 1 sesamoid lateral sub-luxation. Given improvement in angles and 90% of patients satisfied with an average AOFAS postoperative score of 90, the technique seems indicated for treatment of symptomatic hallux valgus deformity with increased DMAA.

To identify the mean normal length of the metatarsals and the most common metatarsal formulas through a simple measurement method, thereby providing surgeons with data for planning treatment on symptomatic individuals with biometric abnormalities of the foot. Methods: We evaluated and measured dorsoplantar weight-bearing radiographs of normal adult feet (83 males and 83 females). Results: We found relative mean lengths for metatarsus I of 125.4 mm for males and 115.1 mm for females; for metatarsus II, 127.8 mm for males and 117.3 mm for females; for metatarsus III, 123.4 mm for males and 113.5 mm for females; for metatarsus IV, 114.2 mm for males and 105.3 mm for females; for metatarsus V, 99.5 mm for males and 91.7 mm for females. The mean forefoot width was 87.1 mm for males and 80.8 mm for females. Conclusion: Feet with index minus occurred most frequently in both sexes, although all three metatarsal formulas can be considered to be normal patterns. The mean normal pattern for males and females respectively was the following: metatarsus I 2.4 mm and 2.2 mm shorter than metatarsus II; metatarsus III 4.4 mm and 3.8 mm shorter than metatarsus II; metatarsus IV 9.2 mm and 8.2 mm shorter than metatarsus III; metatarsus V 14.7 mm and 13.6 mm shorter than metatarsus IV.

Com a finalidade de avaliar a eficácia da técnica cirúrgica, envolvendo a neurectomia por via plantar, transversa, fora da zona de carga, em portadores de neuroma de Morton, 217 pacientes foram submetidos a este tratamento.Um total de 264 pés foram observados, sendo 32,2% no pé direito, 46,1% no pé esquerdo e 21,7% bilateralmente.Quanto ao sexo, foram observadas ocorrências de 86,6% no sexo feminino e 13,4% masculino.Quanto a localização, 83,5% (220 neuromas) estavam presentes no terceiro espaço interdigital, 7,5% no segundo espaço, com presença de bilateralidade em 47 pacientes.O tempo médio de acompanhamento foi de 7,5 anos, variando de 4 a 216 meses, com resultado satisfatório e regulares em 95,8% dos pacientes no total, com apenas 11 pacientes (4,2%) insatisfeitos com o tratamento de forma global.Os autores concluem, por tanto, que a neurectomia por via plantar transversa é uma opção satisfatória, com boa visibilização anatômica do neuroma, evoluindo com boa cicatrização, retorno precoce às atividades e satisfação do paciente com o resultado alcançado.

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RESUMOO calcâneo é o osso do tarso mais fraturado, contudo a fratura-luxação bloqueda do calcâneo é uma condição rara, devido à estabilidade óssea e ligamentar entre o calcâneo, o tálus e o cuboide. Relatamos o caso de uma paciente com fratura-luxação bilateral do calcâneo, com características únicas na literatura: ambas expostas, com luxação bilateral dos fibulares, além de apresentar a interposição bilateral do tendão flexor longo do hálux nos focos de fratura. Uma revisão da literatura identificou apenas 19 casos dessa fratura-luxação já descritos, nenhum deles com a combinação de lesões encontradas neste relato. A fratura do calcâneo pode exibir ampla variedade de lesões associadas que requerem um diagnóstico e um tratamento adequado. Nível de Evidência V; Estudos Terapêuticos; Opinião de Especialista.Descritores: Fratura-luxação; Calcâneo/cirurgia; Articulação talocalcânea; Procedimentos cirúrgicos minimamente invasivos. AbStRActThe calcaneus is the most commonly fractured tarsal bone. However, locked fracture-dislocation of the calcaneus is a rare condition because of the bone and ligament stability between the calcaneus, talus, and cuboid. We report the unique features of a case of bilateral fracture-dislocation of the calcaneus, including open fractures, bilateral fibular dislocation, and bilateral interposition of the flexor hallucis longus tendon at the fracture site. A literature review identified only 19 cases of locked fracture-dislocation, but none of these cases involved the combination of injuries observed in this case. Fracture of the calcaneus may be associated with a variety of injuries requiring proper diagnosis and treatment. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Checkrein deformity is characterized by flexible plantar flexion contracture of the interphalangeal joint and flexible extension contracture of the metatarsophalangeal joint of the hallux. It occurs due to entrapment of the flexor hallucis longus in the callus formation at the fracture site or within scar tissue on lower limb. Currently, there is still no consensus about the best surgical treatment for this deformity. The aim of this study is to report a case of a patient that was treated with a novel approach for the treatment of checkrein deformity of the hallux located in the forefoot, with satisfactory functional outcomes. Level of Evidence V; Therapeutics Studies; Expert Opinion.A deformidade em flexão do hálux é caracterizada pela contractura em flexão da articulação interfalângica e em extensão da articulação metatarsofalângica do hálux. Ocorre devido ao encarceramento do flexor longo do hálux na formação do calo no local da fratura ou no tecido cicatricial do membro inferior. Ainda não há consenso sobre o melhor tratamento cirúrgico para essa deformidade. O objetivo deste estudo é relatar um caso de um paciente que foi tratado com uma nova abordagem para o tratamento da deformidade em flexão do hálux localizado no antepé, com resultados funcionais satisfatórios. Nível de Evidência V; Estudos Terapêuticos; Opinião do Especialista.Palavras-chave: Deformidades articulares adquiridas/cirurgia; Deformidades nos pés; Articulação metatarsofalângica; Traumatismos dos tendões.How to cite this article: Miranda BR, Barroco RS, Nishikawa DRC, Oliveira LZP, Ghani MBA. Checkrein deformity treated through a forefoot approach: a case report. Sci J Foot Ankle. 2019;13(4):259-63.

Objective: To identify the mean normal length of the metatarsals and the most common metatarsal formulas through a simple measurement method, thereby providing surgeons with data for planning treatment on symptomatic individuals with biometric abnormalities of the foot. Methods: We evaluated and measured dorsoplantar weight-bearing radiographs of normal adult feet (83 males and 83 females). Results: We found relative mean lengths for metatarsus I of 125.4 mm for males and 115.1 mm for females; for metatarsus II, 127.8 mm for males and 117. 105.3 mm for females; for metatarsus V, 99.5 mm for males and 91.7 mm for females. The mean forefoot width was 87.1 mm for males and 80.8 mm for females. Conclusion: Feet with index minus occurred most frequently in both sexes, although all three metatarsal formulas can be considered to be normal patterns. The mean normal pattern for males and females respectively was the following: metatarsus I 2.4 mm and 2.2 mm shorter than metatarsus II; metatarsus III 4.4 mm and 3.8 mm shorter than metatarsus II; metatarsus IV 9.2 mm and 8.2 mm shorter than metatarsus III; metatarsus V 14.7 mm and 13.6 mm shorter than metatarsus IV.

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