Physician's Resources: Deformity Correction

Gradual correction of deformities involving the foot and ankle are generally considered congenital or acquired.

Metatarsus Adductus is a deformity in which there is medial displacement or angulation of the metatarsals. This condition is commonly treated by casting and manipulation of the affected area, followed by bracing of the extremity for several months. If conservative measures fail, corrective surgery is indicated. Several procedures have been discussed in the literature according to the age of the patient and severity of the condition.

External Fixation can be used successfully in gradual correction to obtain maximum results with minimal surgical intervention allowing for post-operative management of the deformity.

The goal of the reconstructive procedure is to lower the height of the arch and provide a more stable leg for ambulation.


Clubfoot deformity

Pre-operative condition

Post-operative result, showing good anatomical alignment of the left foot
Case Presentation: Severe Cavo Varus with Clubfoot Deformity.
A 21 year old male at risk of amputation was referred to the DCC. The patient was ambulating with a prosthetic device and had a chronic wound. The patient underwent the Ilizarov procedure to achieve proper alignment and wound closure.
*Personal result will be discussed with possible candidates per request.

Pre-operative condition

Post-operative result, showing good anatomical alignment of the right foot
Case Presentation: Severe Clubfoot Deformity.
The patient wore the circular external fixator for six months. The patient’s right foot was corrected at a rate of 1mm a day. Now, she’s able to wear shoes, and her leg function has improved.
*Personal result will be discussed with possible candidates per request.

Initial x-rays after failed open reduction of Calcaneal Fracture

Valgus rotation and malalignment

External deviation of the foot and medial arch collapse

Gradual correction with External Fixator (back view)

Gradual correction with External Fixator (front view)

Final x-ray demonstrating subtalar joint fusion and rearfoot alignment

Final result Anatomical Alignment leg and foot (back view)

Final result demonstrating restoration of the medial arch (front view)

Final Result (side view)
Case Presentation: Malunion Calcaneal Fracture with a valgus deformity and painful arthritic subtalar joint (talar-calcaneal joint).
Outcome: Gradual correction of the valgus deformity to neutral position in conjunction with a subtalar joint arthrodesis. Partial to full weight-bearing status was recommended and the fixator was removed at 10 weeks.
*Personal result will be discussed with possible candidates per request.

Metatarsus Adductus

MiniRail applied to align the forefoot with the rearfoot

Metatarsal realigment final result
Case Presentation: Metatarsus Adductus, child with medial deviation of metatarsals. Failure of conservative measures including casting and bracing.
Outcome: Gradual correction with realignment of the metatarsals, achieved in 6 weeks followed by physical therapy.
*Personal result will be discussed with possible candidates per request.

Bunion Before Treatment

Bunion Treatment

Bunion Treatment

Bunion Treatment After
Case Presentation: Hallux Abducto Valgus (bunion) Correction, patient with painful malalignment of the first metatarsal.
Outcome: Closing base wedge with application of external fixator with full weight-bearing. Fixator removal in 8 weeks followed by physical therapy.
*Personal result will be discussed with possible candidates per request.