Double-column foot osteotomy to correct flexible valgus foot deformity in children with spastic cerebral palsy

Background Mobile (flexible or correctable) hindfoot valgus deformity is common in children with spastic cerebral palsy (CP). It is accompanied by short lateral and long medial foot column. Patients and methods Eleven ambulatory children (20 feet) having spastic CP (two hemiplegic and nine diplegic) and presenting with mobile (flexible) hindfoot valgus deformity were evaluated neurologically, orthopedically, and radiographically and operated upon in the National Institute of Neuromotor System between September 2012 and September 2013. Double-column foot osteotomy with medial cuneiform closing-wedge resection and cuboid opening-wedge resection without attacking the calcaneus was performed in all of them. Results The results were followed up clinically and radiographically over a period ranging from a year and a half (18 months) to 2 years (24 months), with an average of a year and 9 months (21 months), and were graded into four categories as excellent, good, fair, and poor according to the total calculated score. According to the suggested grading system, there were eight excellent results, eight good results, four fair results, and no poor results. Conclusion Double-column foot osteotomy shortening the medial foot column and lengthening the lateral foot column to correct moderate to severe hindfoot valgus in ambulatory children with spastic CP compared favorably with similar series and offered option for achieving foot alignment, improving pain and skin problems, and avoiding the problems associated with arthrodesis. Level of evidence: the study is type IV therapeutic level of evidence.