[Joint-preserving osteotomy for calcanean malunions]

Area of Science:

• Orthopedic surgery
• Foot and ankle reconstruction
• Traumatology

Context:

• Calcaneal malunions significantly impair foot function due to hindfoot lever arm disruption, impingement, and subtalar joint involvement.
• Post-traumatic subtalar arthritis often necessitates subtalar fusion during malunion correction.
• Joint-preserving techniques offer a potential alternative for specific patient groups.

Purpose:

• To evaluate the efficacy of joint-preserving corrective osteotomy for malunited intra-articular calcaneal fractures.
• To determine if this approach can avoid or delay the need for subtalar fusion.
• To assess functional outcomes in patients undergoing this procedure.

Summary:

• Joint-preserving corrective osteotomy is a viable option for carefully selected patients with intact joint cartilage and good bone quality.
• This technique is applicable to both extra-articular and some intra-articular malunions involving the posterior facet of the subtalar joint.
• Studies show good functional results, with only one patient requiring secondary subtalar fusion in a reported series.

Impact:

• Offers a joint-preserving alternative to corrective subtalar fusion for specific calcaneal malunions.
• Potentially improves functional outcomes and reduces the need for fusion in select patients.
• Highlights the importance of careful patient selection for successful osteotomy outcomes.