Dwyer-Osteotomie

Barg, Alexej; Hörterer, Hubert; Jacxsens, Matthijs; Wiewiorski, Martin; Paul, Jochen; Valderrábano, Víctor

doi:10.1007/s00064-015-0409-5

Cited by 13 publications

(6 citation statements)

References 49 publications

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“…In our study, we have shown tremendous improvement in clinical scores, with mean postoperative VAS, FFI, and AOFAS scores of 1.64, 18.11%, and 80.71, respectively. This is similar to the article by Barg et al 2 that reported a mean final VAS score of 1.1 in his series of patients treated with a slide or closing wedge osteotomy. In addition, our final AOFAS score is comparable to Barg et al 2 and Maskill et al 17 who reported final AOFAS scores of 78.0 and 90, respectively.…”

Section: Discussionsupporting

confidence: 89%

“…This is similar to the article by Barg et al 2 that reported a mean final VAS score of 1.1 in his series of patients treated with a slide or closing wedge osteotomy. In addition, our final AOFAS score is comparable to Barg et al 2 and Maskill et al 17 who reported final AOFAS scores of 78.0 and 90, respectively. We demonstrated a 4.5 degree reduction in Meary angle, similar to the 6.5-degree reduction by Sammarco and Taylor.…”

Section: Discussionsupporting

confidence: 89%

“…The lateral calcaneal slide osteotomy is another popular osteotomy for the treatment of pes cavovarus. Barg et al 2 reported on 31 patients with cavovarus deformity treated with a lateral slide or wedge osteotomy. They demonstrated that VAS pain scores significantly improved from 6.3 to 1.1 and AOFAS scores improved from 33.1 to 78.0.…”

Section: Discussionmentioning

confidence: 99%

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Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot

Chen

Ramanathan

Adams

et al. 2023

Foot & Ankle Orthopaedics

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Background: The Malerba calcaneal Z-osteotomy is an operative procedure to treat the hindfoot varus component of adult cavovarus deformity. Basic science studies support the corrective ability of this osteotomy. However, there have been no published midterm clinical and radiographic results. The purpose of this article is to describe the radiographic and clinical improvement in a series of patients treated with this osteotomy. Methods: A retrospective chart review identified 14 feet in 12 patients from January 2013 to August 2018 who met minimal follow-up criteria. Preoperative visual analog scale (VAS) scores, Foot Function Index (FFI) scores, and American Orthopaedic Foot & Ankle Society (AOFAS) scores were compared with postoperative scores. Preoperative Meary angle, calcaneal pitch, and hindfoot alignment were also compared with postoperative measurements. Complications and radiographic union were recorded. Results: At a mean of 80 months, VAS, FFI, and AOFAS scores improved from 7.86 to 1.64, 57.78% to 18.11%, and 39.57 to 80.71, respectively (all P < .001). At a mean of 15 months, Meary angle, calcaneal pitch, and hindfoot alignment improved from 11.14 to 6.64 degrees ( P < .001), 30.93 to 27.43 degrees ( P = .005), and 19.83 degrees varus to 8.50 degrees varus ( P < .001). There was 1 nonunion and 1 postoperative sural nerve neuralgia, but both patients ultimately did well clinically. There were no instances of postoperative tarsal tunnel syndrome. All patients stated that they would have the procedure done again. Conclusion: The calcaneal Z-osteotomy is an effective method to treat adult hindfoot cavovarus deformity. All patients had good clinical outcomes with minimal complications. Level of Evidence: Level IV, case series.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

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Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot

Chen

Ramanathan

Adams

et al. 2023

Foot & Ankle Orthopaedics

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“…This can be done in several ways, with most surgeons utilizing a lateral calcaneal slide osteotomy or Dwyer lateral closing wedge osteotomy, which serves to shorten the lateral column. 42,50 This induces hindfoot valgus and secondarily centralizes the pull of the ankle dorsiflexors and plantarflexors across the hindfoot.…”

Section: Bony Reconstructionmentioning

confidence: 99%

Evidence-Based Management Strategies for Pediatric Pes Cavus

Rosenwasser¹,

Judd²,

Hyman³

2022

Journal of the Pediatric Orthopaedic Society of North America

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Pes cavus is defined as an abnormal elevation of the medial longitudinal arch of the foot. More than two-thirds of patients with pes cavus are found to have an underlying neurologic diagnosis driving a muscle imbalance within the foot. Expedient clinical diagnosis of underlying pathology is paramount to facilitate proper neuraxial imaging studies and a referral to pediatric neurology. Non-operative management is rarely sufficient and is typically indicated only in cases of mild deformity. Surgical management hinges heavily on physical and radiographic examination findings including the Coleman block test, which can help to determine the need for soft tissue or bony reconstruction. The goal of treatment in pes cavus is to obtain a painless, plantigrade, and supple foot.

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“…Here, various surgical options, such as subtalar arthroereisis (SA), subtalar arthrodesis, calcaneus osteotomies (e.g. Evans-osteotomy or Dwyer-osteotomy) and/or muscle tendon transfers 6-10 have been evaluated. For the conservative treatment of neurologically impaired children with JNF a large variety of orthoses, insoles or plaster retention therapies are used.…”

Section: Introductionmentioning

confidence: 99%

Radiological outcome after treatment of juvenile flatfeet with subtalar arthroereisis: A matched pair analysis of 38 cases comparing neurogenic and non-neurogenic patients

Kubo¹,

Krauspe²,

Hufeland³

et al. 2019

Journal of Children's Orthopaedics

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Purpose Therapy of juvenile neurogenic flatfoot (JNF) with subtalar arthroereisis (SA) is currently under critical clinical investigation. In this retrospective matched pair analysis, the radiological outcome after arthroereisis in paediatric patients with infantile cerebral palsy and JNF was compared with children with juvenile flatfeet (JF) without neurological diseases. Methods From October 2007 to April 2018 80 patients with 149 flatfeet underwent surgery with SA. Inclusion criteria were: 1) JNF or JF with age at surgery ≤ 13 years; 2) treatment with SA; 3) presence of three sets of biplane radiographs (preoperative, postoperative and follow-up (FU)). The radiographs were analyzed for: 1) navicular-cuboidal-index (NCI); 2) talocalcaneal angle anteroposterior; 3) talocalcaneal angle lateral; 4) calcaneal-pitch (CP); and 5) talometatarsal-index (TMTI). Following this, 25 patients with 38 flatfeet could be included. Results The mean age at SA of the JNF group was 9.2 years (JF group: 9.3 years) and the mean time of FU was 35.2 months (JF group: 39.4 months). In comparison with preoperatively, a significant decrease of the NCI was seen in both groups (p = ≤ 0.05 and p = ≤ 0.001) in the FU radiographs. The analysis of CP and TMTI in the JF group also resulted in a significant improvement (p = ≤ 0.001 and p = ≤ 0.05). Overall, the comparison between the JNF and JF group showed no significant differences in regard to the analyzed postoperative parameters. Conclusion Based on this data, treatment of flatfeet by SA in patient with neurological disorders shows an improvement of radiological parameters comparable with neurologically unimpaired patients and might be considered as additional treatment option. Level of evidence: IV

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Dwyer-Osteotomie

Cited by 13 publications

References 49 publications

Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot

Midterm Clinical and Radiographic Outcomes of the Calcaneal Z-Osteotomy for the Correction of Cavovarus Foot

Evidence-Based Management Strategies for Pediatric Pes Cavus

Radiological outcome after treatment of juvenile flatfeet with subtalar arthroereisis: A matched pair analysis of 38 cases comparing neurogenic and non-neurogenic patients

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