Calcaneal Lengthening after Tarsal Bone Fusion for Massive Calcaneus Defect Reconstruction

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Traumatology

Background:

• Calcaneus defects present significant reconstruction challenges.
• Existing methods like graft transplantation and distraction osteogenesis have limitations.
• Current calcaneus lengthening is restricted to bone loss less than 35%.

Purpose of the Study:

• To introduce and evaluate a novel technique combining tarsal bone fusion and gradual calcaneus lengthening.
• To treat patients with massive calcaneus loss due to trauma.
• To assess clinical and radiological outcomes of this combined approach.

Main Methods:

• Retrospective study of six patients from January 2015 to December 2021.
• Performed combined tarsal bone fusion and calcaneus gradual lengthening.
• Assessed outcomes using the American Orthopedic Foot and Ankle Score (AOFAS) and radiological measurements (TCA, CIA, MDA, ALA, CAL).

Main Results:

• Mean calcaneal axial lengthening of 43.8 mm (47.8% of original length).
• Mean external fixation duration of 104.8 days.
• All patients showed corrected deformities with three excellent and three good AOFAS scores after an average 35-month follow-up.

Conclusions:

• The combination of Ilizarov technique with tarsal bone fusion is a viable option for massive calcaneus reconstruction.
• This approach satisfactorily restores foot and ankle function.
• Tarsal bone fusion is crucial for reinforcing the distracted calcaneus, correcting deformities, and enhancing hindfoot stability.