Results of surgical treatment of congenital convex pes valgus (ten nonidiopathic feet)

Congenital pes valgus is a rare and complex deformity of the foot raising serious diagnostic and therapeutic challenges. The purpose of our work was to present the surgical procedures used in our series and to analyze outcome. Ten feet presenting congenital convex pes valgus treated surgically over a six-year period using the same operative technique were reviewed at minimum five years follow-up. Idiopathic deformities were excluded from this series. Deformities were secondary to arthrogryposis in five feet, multiple malformative syndrome in four, and diastematomyelia in one. The surgical technique used two approaches: a posteromedial incision to release the dorsal flexors, disinsert the tibialis posterior, open the talonavicular joint, release the Achilles tendon and release the posterior tibiotalar capsule; a lateral incision to lengthen the fibular tendons and perform an osteotomy of the anterior process of the calcaneum. A talonavicular pin and a calcaneocuboid pin maintained the correction. The tibialis posterior tendon was reinserted on the anterior aspect of the talonavicular capsule after incision of the dislocation chamber. Outcome was considered good in five cases and fair in five. Outcome was fair in the arthrogryposis feet. Undercorrection was observed in two feet and valgus flatfoot in three. Talar necrosis occurred in one foot and navicular necrosis in two. Simultaneous correction of the different anomalies observed in the congenital convex foot was achieved in this series. The anatomic and functional results were satisfactory. We recommend avoiding overly extensive release in order to decrease the risk of talar and navicular necrosis. It is also important to check the reduction radiographically during the operation. Patients should use an orthesis for several months postoperatively to avoid recurrence. Le pied convexe congénital est une malformation rare du pied qui pose plusieurs problèmes d’ordre diagnostique et thérapeutique. De nombreuses techniques de correction chirurgicale ont été proposées. Nous rapportons dix cas de pied convexe congénital non idiopathique, traités chirurgicalement selon la même technique opératoire sur une période de six ans avec un recul minimal de cinq ans. La malformation était secondaire à une arthrogrypose dans cinq cas, à un syndrome polymalformatif dans quatre cas et à une diastématomyélie dans un cas. La technique chirurgicale comportait deux abords : un abord postéromédial permettant une libération des rel