What is Foot/Ankle Surgery - Osteotomy of Metatarsal Bones (Pes Cavus Deformity)?

Summary: Foot/ankle surgery - osteotomy of metatarsal bones is a medical procedure used to correct a condition called pes cavus deformity, which refers to an excessively high arch in the foot. This surgery involves making one or more small cuts in the metatarsal bones of the foot, repositioning them to a more normal position, and securing them with plates, screws, or pins.

Who needs it: This procedure is typically recommended for individuals with pes cavus deformity, a condition characterized by a high arch in the foot that can lead to various issues such as foot pain, instability, difficulty walking, and balance problems. When non-surgical interventions like physical therapy or orthotic devices fail to alleviate the symptoms, this surgery may be recommended.

Procedure: The procedure begins with the patient being placed under general anesthesia, ensuring they are asleep and pain-free throughout. Once the anesthesia sets in, the surgeon makes small incisions around the metatarsal bones in the foot. Using specialized surgical instruments, the surgeon then makes precise cuts in these bones to allow for repositioning. The bones are carefully moved into a corrected alignment to reduce the excessive arch, and they are held in place with plates, screws, or pins. After confirming proper alignment, the incisions are closed with sutures or staples, and a bandage is applied.

Duration: The duration of this surgery varies depending on the complexity of the deformity and the specific techniques used. On average, the procedure can take anywhere from one to three hours.

Benefits: Osteotomy of metatarsal bones aims to correct the pes cavus deformity, alleviating associated foot pain, improving stability, balance, and walking ability. By reducing the excessive arch, pressure is redistributed more evenly across the foot, preventing further complications such as calluses, ulcers, and joint degeneration.

Risks or complications: As with any surgical procedure, there are potential risks and complications. These can include infection, blood clots, excessive bleeding, nerve or blood vessel damage, delayed bone healing, poor wound healing, and the need for further surgery. Additionally, there may be persistent pain, limited range of motion, or stiffness in the foot after recovery.

Recovery: Following the surgery, the patient will typically need to wear a cast, splint, or specialized shoe to protect the foot and help it heal properly. Initially, there will be some discomfort and swelling, which can be managed with pain medication and elevation of the foot. Physical therapy may be recommended to restore strength and flexibility. Recovery time varies, but it often takes several weeks for the bones to heal properly. During this period, weight-bearing may be restricted, and crutches may be necessary. Full recovery, with the ability to return to regular activities, may take several months. It is essential to follow post-operative instructions provided by the surgeon and attend any recommended follow-up visits to ensure a successful recovery.

Symptoms for Foot/Ankle Surgery - Osteotomy of Metatarsal Bones (Pes Cavus Deformity)

Osteotomy of metatarsal bones, also known as metatarsal osteotomy or osteotomy for pes cavus deformity, is a surgical procedure performed on the foot and ankle to correct the abnormal high arching of the foot, known as pes cavus deformity. Here are the typical symptoms associated with this condition that may prompt the need for surgery:

1. High arches: Pes cavus deformity usually presents with a higher-than-normal arch on the bottom of the foot. The arch may appear prominent, causing an elevated and rigid foot shape.

2. Foot pain: The high arch can lead to excessive pressure on specific areas of the foot, particularly the ball of the foot and the heel. This pressure can result in pain, especially during weight-bearing activities like walking or standing for extended periods.

3. Instability: Pes cavus deformity often affects the foot's stability due to the abnormal alignment of the bones and joints. This can make balance and walking more challenging, increasing the risk of frequent ankle sprains or falls.

4. Clawed toes: The excessive arching of the foot may cause the toes to bend downward, resembling a clawed appearance. This can lead to discomfort while wearing shoes and difficulty finding appropriate footwear.

5. Muscle tightness and weakness: In pes cavus deformity, certain muscles in the foot and lower leg can become tight, while others may become weakened or atrophied. This imbalance can further contribute to foot pain, gait abnormalities, and reduced overall function.

6. Nerve symptoms: Sometimes, the high arch can compress nerves in the foot, leading to symptoms such as tingling, numbness, or shooting pain. These sensations may radiate into the toes or other areas of the foot.

If conservative treatments like physical therapy, orthotics, or medication fail to provide relief, an osteotomy of the metatarsal bones may be recommended by a healthcare professional. This surgery aims to correct the deformity, relieve pain, improve foot function and stability, and enhance overall quality of life for individuals with pes cavus deformity. It involves carefully cutting and repositioning the metatarsal (midfoot) bones to achieve a more optimal foot arch and alignment.

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