One-stage correction of multiple brachymetatarsia and hallux valgus with calcaneal autograft

Brachymetatarsia is the shortening of the metatarsus caused by congenital premature closure of the metatarsal physis. In general, the patient presents a shortened and dorsally situated toe causing metatarsalgia in addition to aesthetic effects. The aim of surgery is to improve the symptoms andaesthetics through bone elongation and rebalancing of the metatarsal formula. This elongation may be performed through gradual distraction with an external fixator or a single procedure with a bone graft. We report a case of bilateral brachymetatarsia of the 3rd and 4th metatarsals associated with hallux valgus and deformities in the 2nd toe, in which surgery was performed on the right foot with a calcaneal autograft.Level of Evidence V; Therapeutic Studies; Expert Opinion.

Tibial deformity correction by Ilizarov method

<p class="abstract"><span lang="EN-IN">The case series illustrates the correction of bony deformities of the tibia through a percutaneous osteotomy and gradual distraction with the Ilizarov apparatus in order to restore shape and function of the lower limb. A total of 13 cases of tibial deformity which were gradually corrected by the Ilizarov method were included in the study. The plane and degree of deformity was calculated by Drorr Paley’s method. The tibial deformity was gradually corrected in all patients by the Ilizarov method. Hinges were appropriately placed usually at the level of deformity (CORA). In most of the cases percutaneous osteotomy was done at the level of CORA. In juxta-articular deformities, hinges were placed at the level of CORA but the osteotomy was done at different levels. The mean tibial varus in 12 patients was 24 degrees (range of 18 to 34 degrees) and one patient had a tibial valgus of 22 degrees which was corrected to restore a 90 degree medial proximal tibial angle. No healing problems in the regenerate except for one probable hypertrophic non-union. None of the patients with a tibial varus developed any neurological deficit or compartment syndrome following correction.</span></p>