Valgus deformities of the foot are relatively common in children with cerebral palsy; varus deformities are much less frequent. These deformities add significantly to the difficulty these children have in walking.
Calcaneal osteotomy is an effective corrective procedure for these deformities; it improves weight-bearing alignment of the foot and does not impair subtalar or mid-tarsal joint function. However, calcaneal osteotomy of itself is not the solution for all valgus and varus deformities of the foot. Frequently, supplementary soft-tissue procedures may be required which can be carried out at the same operation. This osteotomy is not technically difficult and can be carried out in children as young as three years of age.
A review of twenty-seven calcaneal osteotomies in twenty children with cerebral palsy is presented; twenty operations were for correction of valgus and seven for correction of varus deformities. The patients have been followed for from two to five and one-half years since calcaneal osteotomy, twenty-six of the feet have been observed for more than two years since osteotomy.
The operative technique, postoperative care, and complications are discussed. Twenty of the twenty-seven operations produced excellent results. Four of the valgus feet showed residual mild valgus deformity at follow-up, and in one varus foot over-correction and valgus deformity developed. In two patients with valgus deformity a progressive varus deformity developed within eighteen months of the calcaneal osteotomy, and further surgery was required.
Copyright 1967 by The Journal of Bone and Joint Surgery, Incorporated