Siegel S Jeffrey
Attending Foot and Ankle Surgeon, MCR Health Services, Bradenton, FL.
J Foot Ankle Surg. 2019 Sep;58(5):1045-1050. doi: 10.1053/j.jfas.2018.12.033. Epub 2019 Jul 23.
Metatarsus adductus is a common transverse plane congenital foot deformity. Achieving anatomic correction can be challenging, as all osteotomy procedures have a steep learning curve. A multitude of complications can occur when using traditional pan-metatarsal osteotomy approaches. The modified Lepird procedure is performed with proximal base osteotomies on all 5 metatarsals oriented dorsal distal to plantar proximal. All screws are inserted parallel to each other, allowing the forefoot to move laterally as a unit. The foot and ankle surgeon is able to dial in with precision the exact amount of forefoot abduction necessary to correct the deformity. The modified Lepird procedure dynamically corrects the metatarsus adductus deformity so it can easily prevent any over- or undercorrection that may occur intraoperatively. The author recommends this procedure when pan-metatarsal base osteotomies are required for correction of metatarsus adductus and associated deformities.
内收型跖骨是一种常见的先天性横平面足部畸形。实现解剖学矫正具有挑战性，因为所有截骨手术都有陡峭的学习曲线。使用传统的全跖骨截骨方法时可能会出现多种并发症。改良的Lepird手术是在所有5根跖骨的近端基底进行截骨，截骨方向为背侧远端至跖侧近端。所有螺钉相互平行插入，使前足能够作为一个整体向外侧移动。足踝外科医生能够精确调整矫正畸形所需的前足外展的确切量。改良的Lepird手术能动态矫正内收型跖骨畸形，因此可以轻松防止术中可能出现的任何过度矫正或矫正不足。当需要进行全跖骨基底截骨来矫正内收型跖骨及相关畸形时，作者推荐此手术。
