Related Experiment Video
Updated: Oct 21, 2025
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Anatomical Study of Sinus Tarsi-Based Lateral Lengthening Calcaneal Osteotomy
Matthias Aurich1,2, Mark Lenz3, Gunther O Hofmann2,3
1Section of Trauma and Reconstructive Surgery, Department of Orthopaedics, Trauma and Reconstructive Surgery, University Hospital Halle, Halle, Saale, Germany.
Background:
Lateral lengthening calcaneal osteotomy (LL-CO) is commonly performed as a treatment for an abducted midfoot in pes planovalgus deformity. The purpose of this study is to investigate potential damage to medial structures with a sinus tarsi LL-CO.
Methods:
Sixteen cadaver feet were used. Eight feet had an extended lateral approach, and 8 had a limited lateral (sinus tarsi) approach. All underwent a sinus tarsi LL-CO. Specimens were then dissected to identify inadvertent injury to medial structures.
Results:
Sinus tarsi LL-CO was associated with damage to the sustentaculum tali and medial articular facets in 56% and 62.5% of specimens, respectively. No anterior or posterior facet injuries were found, although 56% of specimens had a confluent medial and anterior facet.
Conclusion:
Damage to the medial articular facet and sustentaculum is possible with a flat cut sinus tarsi LL-CO due to the curved nature of the relevant sinus tarsi and canal anatomy.
Clinical Relevance:
Sinus tarsi LL-CO needs to be performed with caution since damage to the subtalar joint is possible.
Level Of Evidence:
Level II, prospective cohort study.
