Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results.

Area of Science:

• Orthopaedic Surgery
• Limb Reconstruction
• Trauma Surgery

Background:

• Massive bony loss of the hindfoot, particularly the calcaneus, presents significant reconstructive challenges.
• Traditional methods may involve complex procedures with prolonged recovery times.

Purpose of the Study:

• To introduce a modified technique for tibial calcaneal reconstruction in cases of massive calcaneal bone loss.
• To evaluate the preliminary clinical outcomes and feasibility of this modified approach.

Main Methods:

• A modified tibial calcaneal technique was performed on 10 patients with unilateral calcaneal loss between January 2015 and December 2021.
• Clinical outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Symptom Checklist-90-Revised (SCL-90-R) questionnaire.
• Paired t-tests were used for statistical comparison of pre- and post-operative parameters.

Main Results:

• The mean tibial lengthening achieved was 77.3 mm, with an average external fixation duration of 123.7 days.
• All patients demonstrated well-corrected limb deformities and an average follow-up of 29.7 months.
• Eight patients achieved good and two achieved fair results on the AOFAS score, with improvements noted in SCL-90-R indices.

Conclusions:

• The modified tibial calcaneal technique is a viable option for managing total calcaneal loss, associated with limited complications.
• The simplified procedure facilitates a shortened external fixation period, enabling earlier patient rehabilitation.