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Foot Ankle Clin. 2009 Sep;14(3):489-531. doi: 10.1016/j.fcl.2009.06.001.

Reconstruction of multiplanar deformity of the hindfoot and midfoot with internal fixation techniques.

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Division of Pediatric Orthopaedics and Foot Surgery, Orthopaedic Department, University of Heidelberg, Schlierbacher Landstrasse 200a, Heidelberg 69118, Germany.


Reconstruction surgery of the midand hindfoot is a demanding challenge for foot surgeons. Satisfactory results depend not only on surgical technique and skills but also on the knowledge of underlying disorders, pathomechanics, and indication criteria. The cavovarus foot, the planovalgus foot, and Charcot's foot are some of the most challenging foot deformities, requiring different surgical strategies for their correction. Most of the osteotomies and fusions in children and adults can be fixed with transcutaneous Kirschner wires, which are inexpensive and easy to use and remove. The use of alternative fixation systems such as cannulated screws, compression screws, or angle-stable locking plates depends on patient age, vascular situation, risk for nonunion, and underlying pathology.

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