Abstract
Apert’s syndrome (or acrocephalosyndactyly type 1) is a rare condition characterized by anomalies of the skull (craniosynostosis) in conjunction with complex syndactyly of the hands and feet. There are many studies involving the description and management of hand deformities in Apert’s syndrome. The study of foot anomalies however in children with Apert’s syndrome has been limited to individual case reports and small series. Plain radiographic studies have shown that during childhood, progressive fusion of the bones of the feet occurs. The management of these children’s feet has never been addressed in the literature.
Seven patients with Apert’s syndrome were included in our study. The study group consisted of 2 girls and 5 boys, age range 4–16 years. We performed plain radiography, 3-D computed tomography and paedobarographic studies on all seven children based on our observation that some children with Apert’s had prominent metatarsal heads with symptomatic callosities under the first and second metatarsal heads. Five of the seven children studied demonstrated a specific pattern both on paedobarographic studies and 3D computed tomography of an excessively plantar flexed, fused first and second rays.
A corrective extension osteotomy of the fused first and second rays were then carried out in one patient with an excellent post-operative result. We propose that by early recognition and correction of the pattern of an excessively plantar flexed first and second ray would improve both function and footwear.
The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
