The foot in multiple synostoses syndromes

The clinical features and radiographs of four patients with multiple synostoses syndrome were studied to identify the pattern of tarsal coalition and the foot deformities that occur in this condition. Based on our observations in these patients and the information available in the literature, it is clear that multiple massive tarsal coalitions occur in this condition. The exact pattern of fusion may vary from patient to patient. Some patients have associated foot deformities that characteristically include, severe inversion of the forefoot and milder degrees of hindfoot varus. Hindfoot equinus may occur in a proportion of patients. On account of the rigidity of the deformities, a combined external derotation osteotomy at the midtarsal level and a lateral displacement osteotomy of the calcaneus was needed to make the feet plantigrade.