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[Percutaneous calcaneal sliding osteotomy].

M Walther1, S Kriegelstein2, S Altenberger2

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Summary

This study details a percutaneous v-shaped calcaneal osteotomy for correcting hindfoot deformities. The minimally invasive technique offers effective 3D correction of calcaneal malalignment with good outcomes.

Keywords:
Ankle jointBone malalignmentCalcaneusHeel boneMinimally invasive surgical procedures

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Area of Science:

  • Orthopedic surgery
  • Foot and ankle reconstruction
  • Minimally invasive surgical techniques

Background:

  • Calcaneal malalignment, including varus and valgus deformities and altered calcaneal pitch, requires correction as part of hindfoot procedures.
  • Subtalar joint osteoarthritis and fixed deformities are contraindications for this specific procedure.

Purpose of the Study:

  • To describe the technique and outcomes of a percutaneous v-shaped calcaneal osteotomy for correcting calcaneal malalignment.
  • To evaluate the procedure's effectiveness in 3D correction of the calcaneus within hindfoot reconstruction.

Main Methods:

  • A percutaneous v-shaped calcaneal osteotomy is performed under image intensification, allowing for precise 3D correction.
  • The osteotomy planes are defined to correct varus/valgus deformities and adjust calcaneal pitch.
  • Fixation is achieved using percutaneous screws.

Main Results:

  • The procedure enables correction of calcaneal deformities while preserving soft tissues, often integrated into hindfoot correction (e.g., posterior tibial tendon insufficiency, total ankle replacement).
  • Neurovascular bundle injury rates were comparable to open surgery.
  • Average calcaneal shift was 1 cm, with additional correction possible via tuber calcanei rotation.

Conclusions:

  • Percutaneous v-shaped calcaneal osteotomy is an effective technique for 3D correction of calcaneal deformities.
  • It offers a minimally invasive approach with comparable safety to open procedures for hindfoot reconstruction.