Læknablaðið - 15.11.1986, Page 44

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LÆKNABLAÐIÐ
»stripping«). 170 growing feet (group I) and 41
fullgrown feet (group II) were operated upon. The mean
period of observation in the whole material was 3 Vi
years.
At review it was found that subjective symptoms had
vanished or markedly diminished in 96.3 per cent of
group I (170 growing feet).
The operation also resulted in correction of the
excavatus deformity in 88 per cent of these feet and in
correction of the varus deformity in 76 per cent.
Bearing in mind the above results the author permits
himself to draw the conclusion that this method is suited
for the treatment of pes varo-excavatus congenitus
idiopathicus during the growing period. The best timing
for the operation is about the age of ten to twelve years.
At that age standard conservative measures have
disclosed whether they suffice or not. Then an sample
period of growth remains to give the bones of the foot
sufficient time to grow into normal anatomical form
after the operation, with normalization of the
deformity.
In group II (fullgrown) this operative method gave
satisfactory results as to the subjective symptoms.
However, no measurable correction of the varus or
excavatus deformities of these fully grown and
unyealding feet was encountered. The operation may
therefore be indicated in the fully grown pes
varo-excavatus with increasing pain on exertion and
decreased endurance.
Patients over middle-age often have developed
osteoarthrosis (arthrosis deformans) in the individual
foot joints, due to long standing internal derangement
of bones of the feet. These patients frequently experince
rapidly increasing subjective symptoms and disability.
The described operation is then not indicated. In those
cases major operations on the foot skeleton, such as
corrective subtalar arthrodesis, are often needed.
HEIMILDIR
1. Haraldsson S. Pes plano valgus. Lákartidningen
1963; 60; 1-18.
2. Brewerton DA, Sandifer PH, Sweetnam DR.
»Idiopathic« pes-cavus - an investigation into its
etiology. Br Med J 1963; 2: 659-61.
3. Samilson RL, Dillian W. Cavus, cavovarus and
calcaneocavus. An update. Clin Orthop 1983; 177:
125-32.
4. Steindler A. Stripping of the os calcis. J Orthop
Surg 1920; 2: 8-12.
5. Steindler A. The treatment of pes cavus (hollow
claw foot). Arch Surg 1921; 11: 325-37.
6. Templeton AW, McAlister WH, Sim ID.
Standardization of terminology and evaluation of
osseus ralationships in congenitally abnormal feet.
AJR 1965; 93: 374-80.
7. Davis LA, Hatt WS. Congenital abnormalites of
feet. Radiology 1955; 64: 818-25.
8. Paulos L, Coleman SS, Samuelson KM. Pes
cavovarus. Review of a surgical approach. Using
selective soft-tissue procedures. J Bone Joint Surg
1980; 62A: 942-53.
9. Dwyer FC. The present status of the problem of pes
cavus. Clin Orthop 1975; 106: 254-75.
10. Cole WA. The treatment of claw foot. J Bone Joint
Surg 1940; 22: 895-908.
11. Sherman FC, Westin GW. Plantar release in the
correction of the foot in childhood. J Bone Joint
Surg 1981; 63A: 1382-9.