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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Distraction osteogenesis for complex foot deformities: Gigli saw midfoot osteotomy with external fixation
Journal of Foot and Ankle Surgery, Volume 53, No. 5, Year 2014
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Description
Open midfoot wedge osteotomy correction can cause neurovascular compromise, requires extensive exposure, sacrifices normal joints, and shortens the foot. We used a minimally invasive technique to treat complex foot deformities by combining percutaneous Gigli saw midfoot osteotomy, circular external fixation, and acute, gradual, or gradual with acute manipulation correction. The medical records of 23 patients (26 feet) with complex foot deformities (congenital, 18 feet; neuromuscular, 4 feet; post-traumatic, 3 feet; malunion, 1 foot) who had undergone treatment within an 18-year period (1990 through 2007) were retrospectively reviewed. We also performed the procedure on 10 cadaveric limbs to determine whether anatomic structures were at risk. Correction was achieved in all feet. The mean duration of external fixation treatment was 4.2 (range 3 to 7) months. The mean follow-up duration was 4.7 (range 2 to 18) years. A significant difference was observed in the pre- and postoperative, lateral view, talar-first metatarsal angle (p=.001). Minor complications (4 feet) consisted of bony exostoses. Major complications included recurrent deformity in 3 feet and sural nerve entrapment in 1 foot. Two patients had mild and one moderate foot pain. Three patients had impaired gait function; the remaining patients had functional gait. The mean interval until wearing regular shoes after external fixation removal was 2.3 (range 1 to 4) months. All but 1 of the patients were satisfied with the final results. We observed no cadaveric neurovascular injury. Our results have shown that percutaneous Gigli saw midfoot osteotomy can be performed without neurovascular injury and is capable of successfully correcting complex foot deformities. © 2014 American College of Foot and Ankle Surgeons.
Authors & Co-Authors
Lamm, Bradley M.
United States, Baltimore
Sinai Hospital of Baltimore
Gourdine-Shaw, Monique C.
United States, Bethesda
Walter Reed National Military Medical Center
Thabet, Ahmed M.
Egypt, Benha
Benha University
Jindal, Gaurav
India, Ghaziabad
Pushpanjali Crosslay Hospital
Herzenberg, John E.
United States, Baltimore
Sinai Hospital of Baltimore
United States, Baltimore
University of Maryland School of Medicine
Burghardt, Rolf D.
Germany, Hamburg
Orthopaedic Surgeon
Statistics
Citations: 14
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.1053/j.jfas.2014.04.008
ISSN:
10672516
e-ISSN:
15422224
Research Areas
Violence And Injury
Study Design
Cohort Study