Anterior Wedge Osteotomy of Cole Tarsus

Cole anterior wedge osteotomy is used for the surgical treatment of high arch. High arched foot refers to an abnormal increase in the arch of the foot. It is often accompanied by a series of deformities, including claw-toed (extension of the metatarsophalangeal joint and flexion of the interphalangeal joint), rotation of the forefoot and adduction, increased "bone" on the dorsal side of the midfoot and wrinkles on the medial side of the plantar and paralysis The membrane collapses, the lateral margin of the foot is extended and the medial shortening, the humeral head chin, varying degrees of subtalar joint stiffness, heel varus, and Achilles tendon contraction with or without clubfoot contracture deformity. Through detailed physical examination, electromyography and neurological studies and imaging studies, the etiology of more than 80% of children can be determined. In children with mature bones, the cause is often neuromuscular disease or trauma. Common neuromuscular diseases include progressive neuromuscular atrophy and polio, and trauma is caused by the sequelae of deep fascial compartment syndrome in the posterior aspect of the calf after fracture of the tibia. Spinal insufficiency, cerebral palsy, primary cerebellar disease, joint contracture or severe congenital clubfoot can also develop high arch deformity. Some sick children can not find a clear cause, and are idiopathic high arch deformity. The treatment plan should be determined according to the age of the sick child, the type of deformity, and the degree. Treatment of diseases: congenital high arch Indication Cole anterior wedge osteotomy is suitable for the treatment of mild to moderate high arch deformity of the midfoot. Preoperative preparation 1. Before the operation, the X-ray film of the standing position of the foot should be taken to understand the position and deformity of the forefoot, midfoot and hindfoot, especially the plantar flexion and claw-toe deformity of the first metatarsal. . 2. The skin preparation of the affected foot begins 3 days before surgery. Surgical procedure 1. Incision and exposure Make a longitudinal incision in the midline of the foot, starting from the proximal side of the medial ankle and extending distally to the middle of the humerus. The extensor tendon was separated between the third and fourth extensor tendons, and the periosteum was cut longitudinally to the sides to reveal and confirm the tibia. 2. Osteotomy A vertical transverse osteotomy from the midpoint of the scaphoid and the tibia to the underside of the tibia, then a second osteotomy line on the far side of the first osteotomy line, and an osteotomy below the tibia Line connections. The distance between the two osteotomy lines (the width of the wedge-shaped osteotomy block) is determined according to the severity of the deformity. 3. Guanchuang Raise the forefoot, align the osteotomy, suture the periosteum intermittently, suture the skin, skin, and aseptically dress.