A Comparative Study Of Calcaneal Osteotomy And Non-Osteotomy In The Treatment Of Flexible Cavovarus Foot

Objective: To compare the short-term clinical effects of calcaneus osteotomy and noncancaneus osteotomy in the treatment of flexible cavovarus deformity.Methods: The clinical data of 38 patients(42 feet)with flexible cavovarus treated in the foot and ankle surgery Center of our hospital from September 2018 to May 2019 were analyzed retrospectively.There were 20 cases(22 feet)in the calcaneus osteotomy group,including 7 male patients(7 feet).There were 13 female patients(15 feet),with an average age of(24.59 ±5.36)years.There were 18 cases(20 feet)in the calcaneus non-osteotomized group,including 7 male patients(7 feet)and 11 female patients(13 feet).The average age was(23.60 ±4.51)years.The functional scores of the ankle and hindfoot joint of the American Orthopaedic foot Association(American orthopedic foot and ankle society,AOFAS)and the visual analogue scale(Visual analogue score,VAS)of pain during movement and the imaging parameters were collected before operation.during the postoperative follow-up,in addition to collecting the above data one by one,we should also investigate the satisfaction of the surgical results,compare the clinical data before and during follow-up,and evaluate the clinical effects of the two surgical methods.Results: The wounds of 38 patients(42 feet)in the two groups healed in the first stage,and there were no wound complications such as wound infection and skin necrosis.In the calcaneus non-osteotomy group,3 patients(3 feet)developed mild posterior foot varus deformity during the follow-up one year after operation,and the patients had no obvious clinical symptoms,and the posterior varus deformity was improved by customized orthopedic insole.In the calcaneus osteotomy group,1 patient(1 foot)developed metastatic plantar pain when walking under normal shoes in 4 months,and the symptoms disappeared after orthopedic insoles.Two patients(2 feet)developed plantar numbness after operation,and the symptoms gradually disappeared after administration of neurotrophic drugs.Intra-group comparison: the average postoperative AOFAS score of the two groups was significantly higher than that before operation,the average VAS was also significantly lower than that before operation,and the imaging parameters were also significantly improved.Comparison between the two groups: there was no significant difference in the average AOFAS score and VAS score between the two groups during the follow-up,and there was a significant difference in the CVA of the hindfoot aligment between the two groups during the postoperative follow-up(P < 0.05).Conclusion: For the treatment of flexible cavovarus deformity combined with calcaneus osteotomy can obtain a better hindfoot aligment,the ability to correct the deformity is more significant,and the clinical prognosis is improved more obviously.