Severe contraction
deformities of the foot, e.g. after
trauma or spasticity, often lead to an inability to walk and can, in part, only be rectified by corrective bone
osteotomy of the hind and middle foot. In this article, we discuss hind and middle foot
osteotomies in cases of severe
foot deformities in adolescents and adults. The surgical techniques of Lambrinudi, Imhäuser and Lelièvre will be considered. The surgical technique of Lambrinudi uses a triple
arthrodesis between the talus, calcaneus and navicular bones, and the cuboid bone, in addition to the removal of a bone wedge from the talus for correction of the
talipes equinus deformity. Severe contraction
talipes calvus can be straightened and capable of loading using Imhäuser's technique with wedge
osteotomy and
arthrodesis in Chopart's joint. The planigrade position is achieved by the removal of a dorsolaterally based wedge from Chopart's joint. Using Lelièvre technique, severe contraction club foot with hind foot varus can be treated with a wedge from Chopart's joint and the talocalcaneal joint with
arthrodesis. For stabilization, a compression clamp system is used. The advantages of the system used by us is that, in comparison with other systems, it can also be used for sclerotic bones as the shank is not hammered in but is introduced after boring. Using the compression clamp system, good stability and a high rate of osseous blood circulation can be achieved using
osteotomies and
arthrodeses. The aim of surgery is, in all cases, the correction of the
deformity, functional improvement and the elimination of pressure points and
pain.