Congenital split feet in children: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Congenital split foot deformity is a complex developmental disorder, accompanied by the absence of one or more metatarsal bones and fingers, a deep cleft in the entire depth of the forefoot.
ICD Code 10
Q66.8 Congenital split deformity of the feet.
Classification of congenital split foot
Depending on the severity of the lesions, light, moderate and severe lesions are isolated. An easy degree of deformation is characterized by the presence of a shallow foot cleft reaching the diaphytes of metatarsal bones, the absence of 1-2 toes of the foot while maintaining all metatarsal bones. At an average degree of severity of the deformity, the foot cleft ends at the level of the middle third of the metatarsal bones, one or two metatarsal bones absent. A severe degree of deformation is characterized by underdevelopment or the absence of two or three centrally located fingers and metatarsal bones, a deep cleft in place of absent fingers reaching the Lisfranc joint, always accompanied by varus or valgus deformation of the fingers, clinodactyly. Often the splitting of the feet is accompanied by other developmental anomalies in the anterior part of the foot - syndactyly, brachymetatarism, congenital constrictions of the feet.
Treatment of congenital split foot
Indication for surgical treatment is a split foot of heavy and medium severity. Operative treatment is given to children from the age of one year.
Correction of the deformities of the feet involves the removal of the cleft, the formation of the interdigital space, the decrease in the width of the foot due to the wedge resection of the tarsi bones and the approach of the remaining metatarsal bones with the use of osteosynthesis by an autograft from the remote metatarsal bone or the formation of a bone bridge in the form of a petal bridge from the lateral surfaces of metatarsal bones and other types of fixation .
The deformation of the fingers is corrected by shortening the resection of the phalanges of the fingers, the capsulotomy of the interphalangeal and metatarsophalangeal joints with the transplantation of the tendons and the subsequent fixation by the Kirschner knitting needles and the plaster bandage.
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