Using Geometry for the Dorsiflexory Wedge Osteotomy of the First Metatarsal |
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| Affiliation: | 1. Chief Resident, Temple University Hospital Podiatric Surgical Residency Program, Temple University Hospital, Philadelphia, PA;2. Associate Professor, Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA;1. Department of Emergency Medicine, University of Oklahoma College of Medicine, Tulsa, OK, USA;2. AirEvac Lifeteam, O''Fallon, MO, USA;3. The Center for Medical Transport Research, Columbus, OH, USA;1. Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria, Rome, Italy;2. Department of Orthopaedic and Trauma Surgery, Humanitas Research Hospital, Rozzano, Milan, Italy;3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England;4. Department of Musculoskeletal Disorders, University of Salerno School of Medicine and Surgery, Salerno, Italy;1. Director, Foot and Ankle Surgery Residency Program, Regions Hospital/HealthPartners Institute for Education and Research, St Paul, MN;2. Chief Resident, Foot and Ankle Surgery, Regions Hospital/HealthPartners Institute for Education and Research, St Paul, MN;1. Department of Orthopaedics and Traumatology, Azienda Ospedaliera Universitaria Integrata di Verona, Italy |
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| Abstract: | Dorsiflexory wedge osteotomy is indicated for the correction of structural and irreducible first metatarsal deformity to effectively shorten and elevate a plantar flexed first ray. This is most commonly due to fixed forefoot valgus deformity, the cavovarus foot type, and diabetic foot pathologic features involving an ulceration or preulcerative area on the plantar aspect of the first metatarsal head. Surgeons can subjectively judge the amount of correction, such as by restoring the frontal plane alignment of the forefoot, or objectively by returning Meary's angle to a parallel relationship on a weightbearing lateral radiograph. With this tip, we propose an objective measurement, with calculation and use of Meary's angle, to preoperatively quantify the amount of desired correction. In the present study, we applied basic geometric principles based on triangles to calculate the relationship between the width of the excised wedge and the angular degrees of achieved dorsiflexion. We hope these data will provide both objective and reasonable estimates for reconstructive foot and ankle surgeons working with these deformities and with this procedure. |
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| Keywords: | bone model cavus foot DFWO geometry plantar metatarsal head ulcer wedge osteotomies |
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