Opening Cuboid Wedge Osteotomy (Zoom Osteotomy) for Triplanar Correction of Flexible Pes Planovalgus Deformities.

Surgical correction of flexible pes planovalgus often involves reestablishing the length of the lateral column. This is a review of a cohort of patients who underwent an opening cuboid osteotomy with interpositional graft for triplanar correction of flexible pes planovalgus. The medical records of 35 patients involving 51 feet were reviewed. All patients were treated with an opening wedge osteotomy of the cuboid in combination with adjunctive procedures as needed for correction of the pes planovalgus deformity. Radiographs were obtained before and a minimum of 12 months after surgery. Preoperative and postoperative cuboid abduction and Meary's (lateral talometatarsal) angles were measured using the radiographs, and adjunctive procedures and complications were recorded. Mean follow-up was 46 (range, 12-85) months. The mean cuboid abduction angle improved from 20.3° (range, 8°-31°) to 6.6° (range, 0°-15°), and the mean Meary's angle improved from 10.5° (range, 0°-25°) to 2° (range, -3° to 15°). All patients also underwent adjunctive procedures at the time of cuboid osteotomy. In the 51 feet treated, there were 3 (6%) complications, including wound dehiscence, neuritis, and deep vein thrombosis. There were no recurrences. Triplanar correction of flexible pes planovalgus can be performed safely and successfully with an opening cuboid osteotomy as an alternative to the Evans Osteotomy.

Effect of Vibram FiveFingers Minimalist Shoes on the Abductor Hallucis Muscle.

BACKGROUND: This study investigated the effect of Vibram FiveFingers Bikila minimalist shoes on intrinsic foot musculature. We hypothesized that a gradual transition into minimalist shoes will increase the thickness of the abductor hallucis muscle. METHODS: Forty-one individuals were divided into four groups: control (traditional shod) (n = 9), restricted walking in Vibram FiveFingers (n = 11), running in Vibram FiveFingers (n = 10), and unlimited walking in Vibram FiveFingers (n = 11). At baseline, 12 weeks, and 24 weeks, the thickness of the abductor hallucis muscle was determined using ultrasound. Statistical analysis was performed to determine the significance of differences in muscle thickness at the three different time points. RESULTS: The mean thickness of the abductor hallucis muscle at 24 weeks was significantly greater than that at baseline for the restricted walking (P = .005) and running (P < .001) groups. In the unlimited walking group, the mean thickness of the muscle at 12 weeks was significantly greater than that at baseline (P < .05) but not at 24 weeks. There were no significant differences in muscle thickness among the three time points for the control group (P = .432). CONCLUSIONS: This study demonstrated that wearing Vibram FiveFinger Bikila footwear over a controlled period of time, an unlimited amount of time, as well as transitioning runners over a 6-month period of time using the 10% philosophy for increasing mileage, significantly increases intrinsic muscle thickness of the abductor hallucis. The abductor hallucis muscle aids in support of the medial longitudinal arch, and an increase in this muscle thickness may help reduce running-related injuries thought to arise from arch weakness.