A prospective study of Japas′ osteotomy in paralytic pes cavus deformity in adolescent feet

Abstract

Background:Pes cavus is a progressive and ugly deformity of the foot. Although initially the deformity is painless, with time, painful callosities develop under metatarsal heads and arthritis supervenes later in feet. Mild deformities can be treated with corrective shoes, or foot exercises. However, in others, operative treatment is imperative. Soft tissue operations are largely unsatisfactory and temporary. Bony operations give permanent correction. We present our series of 18 patients of pes cavus in the adolescent age group, treated by Japas' V-osteotomy of the tarsus.Materials and Methods:18 patients of paralytic pes cavus deformity were treated by Japas osteotomy, between March 1995 and 2005, at our institute. The age of the patients ranged from 8.6 to 15 years (mean 11.3); 10 were boys and 8 girls. All cases had unilateral involvement, and all, but one, were post-polio cases.Result:The mean follow-up is 5.4 years. Of the 18 patients, 14 had excellent or good corrections; 4 had poor correction/complications. However, those patients could be salvaged by triple arthordesis or Dwyer's calcaneal osteotomy.Conclusion:Japas' osteotomy is a satisfactory option for correction of pes cavus deformity in adolescents. In patients who have rigid hind foot equinus or varus, however, the results are compromised.

A prospective study of midfoot osteotomy combined with adjacent joint sparing internal fixation in treatment of rigid pes cavus deformity

“…For severe deformities, bone resection treatment would be either insufficient or excessive and could lead to mediotarsal joint space arthritis, so severe pes cavus cases were excluded from the present study. Although midfoot osteotomy has been confirmed to be effective for the treatment of pes cavus, there are still considerable complications, especially degeneration of the adjacent joints and pain and dysfunction of the ankle and foot [22,23]. In our results, no postoperative deterioration was found in the osteoarthritis of the adjacent joints; in all cases, no obvious decrease of the foot and ankle mobility was found.…”

Evaluation and Management of Cavus Foot in Adults: A Narrative Review

“…However, when the apex of the cavus foot deformity is located in the midfoot, the correction in the apex of the osteotomy is unavoidable. A variety of midfoot osteotomy methods have been described in detail in the previous section, among which the Cole, Japas, and Akron have been repeatedly reported for cavus foot correction [58,59,62,63,66,68]. The Cole is by far the most widely accepted all over the world [10].…”

“…The hindfoot alignment, the Maryland Foot Score, and gait analysis were significantly improved post-operation. In 2009, Protyush Chatterjee [66] reported that the Japas osteotomy was used to correct cavus foot caused by poliomyelitis. The clinical data on 18 cases from 1995 to 2005 were analyzed retrospectively, which concluded that the Japas osteotomy was an ideal choice for adolescent cavus foot correction.…”

Corrective Osteotomies Used in Cavus Reconstruction

“…With a 5-year follow-up, only 4 patients required further procedures, such as calcaneal osteotomies. 24 Jahss has described a tarsometatarsal truncated wedge arthrodesis, which is uncommonly performed as a single entity for anterior cavus. 20 The difficulty with this arthrodesis is the potential for imbalance of the metatarsal heads, nonunions, and the hardware removal.…”