[Posttraumatic deformity correction at the foot]

Abstract

Posttraumatic foot deformities requiring correction result from overlooked or inadequately treated injuries and, on the other hand, from protracted courses because of avascular necrosis, non-union or infection after primary surgery. To achieve a maximum benefit, corrective surgery has to be carried out early before arthritic involvement of adjacent joint becomes evident. As salvage procedures, arthrodeses should be restricted to the affected joints. Especially talus malunion and non-union should be corrected with preservation of the joints whenever possible to achieve favourable functional outcomes. In case of calcaneal malunion with consequential lateral translation a reorientating subtalar arthrodesis should be supplemented by corrective osteotomy of the fracture line. Corrections at the level of Chopart's and Lisfranc's (mid-tarsal and tarsometatarsal) joints must restore the exact relationship between the medial and lateral foot columns. Malunions of the metatarsals and toes are corrected in cases of symptomatic malalignment. This paper reviews corrective procedures for posttraumatic deformities at the different foot regions. A therapy-based classification for mal-unions of the talus and calcaneus is proposed.