Two-stage corrective operation for the treatment of pes cavovarus in patients with spina bifida

Table 1 Functional motor level of patients (n = 19)

Functional motor level	Number of patients
Mid-lumbar	9
Low-lumbar	2
Sacral	8

Table 2 Additional soft tissue and osseous procedures performed

Soft tissue and osseous procedures	Number of patients undergoing procedure
Talonavicular joint capsule release	19
Abductor hallucis release	19
Tibialis posterior lengthening/release	18
Peroneus longus to peroneus brevis transfer	13
Jones transfer (extensor hallucis longus transfer to first metatarsal neck)	10
Flexor hallucis longus lengthening/release	9
Flexor digitorum longus lengthening/release	9
Great toe interphalangeal joint fusion	7
Achilles tendon lengthening	6
Calcaneocuboid joint capsule release	4
Extensor hallucis longus to extensor hallucis brevis transfer	2
Tibialis anterior lengthening	1
Split posterior tibial tendon transfer to peroneus brevis	1
Anterior tibial tendon transfer to lateral cuneiform	1

Table 3 Radiographic outcomes data (n = 11)

Angle measurement	Average preoperative value (range)	Average value after stage 11 (range)	Average value after stage 2 (range)	P value preoperative to post-stage 12	P value post-stage 1 to post-stage 22	P value preoperative to post-stage 2
Meary’s	17.9 ± 13.1 (3.0-50.1)	13.8 ± 7.1 (4.4-25.3)	4.7 ± 10.3 (-8.0 to 21.)	0.47	0.056	0.016a
Calcaneal pitch	22.4 ± 4.0 (16.4-29.6)	25.0 ± 6.3 (15.8-32.7)	21.3 ± 7.6 (12.3-32.4)	0.30	0.30	0.53
AP TMT1	20.6 ± 15.1 (6.2-40.8)	8.4 ± 7.4 (1.4-21.5)	9.3 ± 5.5 (1.5-22.9)	0.066	0.78	0.011a
Lateral talocalcaneal	43.6 ± 9.8 (22.9-57.9)	42.6 ± 10.7 (26.2-53.0)	41.7 ± 9.2 (27.5-51.1)	0.85	0.86	0.46
AP talocalcaneal	15.8 ± 6.7 (6.3-25.0)	16.7 ± 9.8 (3.5-29.7)	18.9 ± 8.6 (8.7-33.9)	0.81	0.62	0.32
Talonavicular coverage	-10.3 ± 9.6 (-28.3 to 1.2)	-4.0 ± 7.2 (-11.0 to 9.3)	-3.8 ± 10.1 (-22.1 to 16)	0.16	0.97	0.025a

¹7 of 11 patients had available radiographs taken between the first and second stages of the operation.

²Values calculated using two-sample t-test with unequal variances.

^aP < 0.05.

AP-TMT1: Anteroposterior talo-first metatarsal.

Table 4 Wicart grading system for correction of pes cavovarus with respect to postoperative lateral Meary’s angle

Correction score	M
Very good	0 ≤ M < 5
Good	5 ≤ M < 15
Fair	15 ≤ M < 20
Poor	M ≥ 20 or need for revision surgery

M: Meary’s angle.