COTTONOSTEOTOMY:TechniqueandComplications

INTRODUCTIONThe Cot ton oste otomyis a medialcune iform openi ngwed ge oste otomywith the wedg e base d dors al ly topl ant ar flex th e media l co lu mn (1). It has been trad iti onall yus ed in co nju nctio n with oth er pro cedu res to co rrect a pe spl anovalgus foot wi th forefoot va rus defo rm it y. The authormost comm only uses the proc edure as an adjunctto anEva ns ca lcan eal os teoto my and ga str ocn emiu s rec essi on forcorr ect ion of a flexib le pedi atric pes pl ano valg us de for Cot ton oste otomy has additi onall ybeen use dfor hall uxlimi tus , me ta ta rsus primusel eva tus, as an add itiona lproc edurein adult flatfootcorr ec tion, and for efoo tsupinatus. Al ter na ti ves to thi s pr oc edur e inclu de any varie tyof medial co lumn fusion s suc h as a na viculo cun eifo rm joi ntar thr ode sis or fir st met at ar soc uneiform joint art hr odesi s,a plant arf lex ory first met atar sa l osteotomy, or soft ti ssu emedia l arc h rec ons tructio nt ag es to th e Cot ton ost eoto my co mparedto thelat ter li st of pro cedu res is it s si mpli cit y, reliableresul ts, easeof intr aope ra tive adjust ab ili ty, and pr eser vat ion of themedi al columnjoints (2, 3).

INTRODUCTION TheCottonosteotomyisamedialcuneiformopening wedge osteotomy with the wedge based dorsally to plantarflexthemedialcolumn(1).Ithasbeentraditionally

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