Tibial Nerve Palsy After Lateralizing Calcaneal Osteotomy

Area of Science:

• Orthopedic Surgery
• Podiatric Surgery
• Nerve Injury

Background:

• Lateralizing calcaneal osteotomy (LCO) is a standard surgical technique for correcting hindfoot varus.
• While various complications are documented, tibial nerve palsy is infrequently reported after LCO.
• This study investigated the hypothesis that tibial nerve palsy is a common complication following LCO.

Purpose of the Study:

• To evaluate the incidence of tibial nerve palsy after lateralizing calcaneal osteotomy (LCO).
• To assess the association between LCO characteristics (tarsal tunnel volume reduction, osteotomy position) and tibial nerve palsy.
• To identify potential risk factors for tibial nerve palsy post-LCO.

Main Methods:

• Retrospective review of 15 patients (18 feet) who underwent LCO for hindfoot varus between 2007 and 2013.
• Exclusion of patients with pre-existing neurological conditions.
• Clinical examination for tibial nerve deficit and computed tomography (CT) scans to evaluate tarsal tunnel volume, osteotomy distance, and lateral shift.

Main Results:

• Tibial nerve palsy was observed in 3 out of 18 operated feet (16.7%) at a mean follow-up of 51 months.
• No statistically significant difference in mean tarsal tunnel volume reduction was found between feet with and without neurological deficit.
• The study did not establish a correlation between increased tarsal tunnel volume reduction, anterior osteotomy placement, or larger lateral shift and the occurrence of tibial nerve palsy.

Conclusions:

• Tibial nerve palsy is a potential complication of lateralizing calcaneal osteotomy, occurring in 16.7% of cases in this series.
• The study failed to demonstrate a significant association between specific LCO surgical parameters and the development of tibial nerve palsy.
• Further research is needed to elucidate the exact mechanisms and risk factors contributing to tibial nerve palsy after LCO.