Metatarsal Osteotomy for the Correction of Adduction of the Fore Part of the Foot in Children

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Abstract
1. Metatarsal osteotomy is a satisfactory method of correcting persisting fixed adduction of the fore part of the foot, regardless of cause, in a child six years old or older. 2. Intramedullary fixation by a Steinmann pin in the first and fifth metatarsals combined with a below-the-knee plaster cast maintained for six weeks is the preferred form of postoperative immobilization. 3. Metatarsal osteotomy in forty-four feet operated on because of resistant adduction of the fore part of the foot after treatment for congenital club foot produced thirty-seven good or excellent results. Metatarsal osteotomy in eighteen feet operated on because of recurrent or resistant metatarsus adductus produced seventeen good or excellent results. Metatarsal osteotomy in fifty-three feet operated on to correct resistant adduction of the fore part of the foot in patients with poliomyelitis, cerebral palsy, idiopathic cavoadductus, myelodysplasia, and a group of miscellaneous causes produced forty-three good or excellent results. 4. Metatarsal osteotomy can be combined with other surgical procedures as a two-stage procedure designed to correct either valgus or varus deformity of the hind part of the foot. Such procedures as the Grice extra-articular subtalar bone graft, the Dwyer calcaneal osteotomy, or triple arthrodesis may precede or follow the metatarsal osteotomy.

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