TY - JOUR
T1 - Consensus for the Indication of a Medializing Displacement Calcaneal Osteotomy in the Treatment of Progressive Collapsing Foot Deformity
AU - C. Schon, Lew
AU - de Cesar Netto, Cesar
AU - Day, Jonathan
AU - Deland, Jonathan T.
AU - Hintermann, Beat
AU - Johnson, Jeffrey E.
AU - Myerson, Mark S.
AU - Sangeorzan, Bruce J.
AU - Thordarson, David B.
AU - Ellis, Scott J.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Recommendation: There is evidence that the medial displacement calcaneal osteotomy (MDCO) can be effective in treating the progressive collapsing foot deformity (PCFD). This juxta-articular osteotomy of the tuberosity shifts the mechanical axis of the calcaneus from a more lateral position to a more medial position, which provides mechanical advantage in the reconstruction for this condition. This also shifts the action of the Achilles tendon medially, which minimizes the everting deforming effect and improves the inversion forces. When isolated hindfoot valgus exists with adequate talonavicular joint coverage (less than 35%-40% uncoverage) and a lack of significant forefoot supination, varus, or abduction, we recommend performing this osteotomy as an isolated bony procedure, with or without additional soft tissue procedures. The clinical goal of the hindfoot valgus correction is to achieve a clinically neutral heel, as defined by a vertical axis from the heel up the longitudinal axis of the Achilles tendon and distal aspect of the leg. The typical range when performing a MDCO, while considering the location and rotation of the osteotomy, is 7 to 15 mm of correction. Level of Evidence: Level V, consensus, expert opinion.
AB - Recommendation: There is evidence that the medial displacement calcaneal osteotomy (MDCO) can be effective in treating the progressive collapsing foot deformity (PCFD). This juxta-articular osteotomy of the tuberosity shifts the mechanical axis of the calcaneus from a more lateral position to a more medial position, which provides mechanical advantage in the reconstruction for this condition. This also shifts the action of the Achilles tendon medially, which minimizes the everting deforming effect and improves the inversion forces. When isolated hindfoot valgus exists with adequate talonavicular joint coverage (less than 35%-40% uncoverage) and a lack of significant forefoot supination, varus, or abduction, we recommend performing this osteotomy as an isolated bony procedure, with or without additional soft tissue procedures. The clinical goal of the hindfoot valgus correction is to achieve a clinically neutral heel, as defined by a vertical axis from the heel up the longitudinal axis of the Achilles tendon and distal aspect of the leg. The typical range when performing a MDCO, while considering the location and rotation of the osteotomy, is 7 to 15 mm of correction. Level of Evidence: Level V, consensus, expert opinion.
KW - AAFD
KW - MDCO
KW - PCFD
KW - adult-acquired flatfoot deformity
KW - calcaneal osteotomy
KW - flatfoot
KW - hindfoot valgus
KW - medial displacement calcaneal osteotomy
KW - medial slide
KW - progressive collapsing foot deformity
UR - http://www.scopus.com/inward/record.url?scp=85089870753&partnerID=8YFLogxK
U2 - 10.1177/1071100720950747
DO - 10.1177/1071100720950747
M3 - Review article
C2 - 32844661
AN - SCOPUS:85089870753
VL - 41
SP - 1282
EP - 1285
JO - Foot and Ankle International
JF - Foot and Ankle International
SN - 1071-1007
IS - 10
ER -