[Heyman's operation for the treatment of congenital metatarsus varus]

Published online: Sep 27 1994

L De Palma, A Tulli, and S P Sabetta.

Università Cattolica del S. Cuore, Roma Istituto di Clinica Ortopedica, Italia.


The authors report their experience with the operation of Heyman, i.e. complete release of the tarsometatarsal and intermetatarsal joint for the treatment of congenital metatarsus varus. This operation of Heyman is capable of meeting the requirements of correction if the indications are precise and if the surgical technique is perfect. The operation is indicated in cases of varus over 15 degrees, passively reducible, with good axes of the hindfoot and without bony alterations of the Lisfranc joint, in children between 3 and 8 years old. There should be a dorsal and medial capsulotomy, with section of the medial 2/3 of the plantar aspects of tarsometatarsal and intermetatarsal capsules; the lateral portion, the lateral 1/3 of the capsule and the insertions of the fibularis brevis and tibialis anticus should be spared. A complete capsulotomy is not indicated owing to the risk of dislocation of the tarsometatarsal joint. The correction should be stabilized during the operation by Kirschner wires to avoid a loss of correction when putting the foot in plaster.