Osteotomy of the medial sphenoid bone in the correction of equine-plano-valgus deformity of the feet in children with cerebral palsy

Introduction. Equino-plano-valgus deformity (EPVD) is one of the most common orthopedic pathologies in children with cerebral palsy. During surgical correction of such deformities, supination of the anterior section (elevation of the first metatarsal bone) may occur, which contributes to the loss of support of the head of the first metatarsal bone. Aim: to analyze the effectiveness of osteotomy modeling the forefoot in surgical treatment of EPVD in children with spastic diplegia associated with cerebral palsy.

Materials and methods. There were examined thirty two 8 to 18 years children (64 feet) with the diagnosis of EPVD against the background of cerebral palsy, spastic diplegia, II-III level according to GMFCS, surgically treated at the National Medical Research Center of Children’s Health. The study group consisted of 15 children (30 feet) who underwent surgical treatment of EPVD using techniques that lower the first metatarsal bone. The control group consisted of 17 children (34 feet) who underwent surgical treatment of EPVD using standard techniques without intervention on the forefoot. Statistical analysis of the studied indices was based on the search for statistical differences in the groups and was performed in the STATTECH software (Stattech, Russia).

Results. After surgical correction of foot deformities, the degree of elevation of the first metatarsal bone decreased by 30.6 ± 6.2%, and the intermetatarsal angle decreased by 5 ± 2° (p = 0.003), indicating the effectiveness of wedge-shaped bone osteotomy in correcting these parameters in patients with cerebral palsy.

Conclusion. Osteotomy of the medial cuneiform bone is an effective way to eliminate the elevation of the first metatarsal bone after correction of EPVDS in children with cerebral palsy.

Contribution:
Zubkov P.A., Zherdev K.V. — research concept and design of the study;
Zubkov P.A., Petel’guzov A.A. — collection and processing of material;
Zubkov P.A. — statistical processing;
Zubkov P.A., Petel’guzov A.A., Chelpachenko O.B. — writing the text;
Zherdev K.V., Butenko A.S., Pimburskiy I.P., Timofeev I.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: September 10, 2025
Accepted: October 02, 2025
Published: October 30, 2025

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