TY - JOUR
T1 - Geometry of the lateral sliding, closing wedge calcaneal osteotomy
T2 - Review of the two methods and technical tip to minimize shortening
AU - Kraus, Jonathan C.
AU - Fischer, Mark T.
AU - McCormick, Jeremy J.
AU - Klein, Sandra E.
AU - Johnson, Jeffrey E.
PY - 2014/3
Y1 - 2014/3
N2 - Background: A lateral closing wedge osteotomy is used for correction of varus hindfoot deformities. Since its original description, different techniques and geometries of the calcaneal bone wedge resection have been described. Even though the techniques seem similar, very different final bone architectures result from each technique, the effects of which are not known. This paper explores several of these techniques and the implications in deformity correction as well as the secondary effects of calcaneal shortening. Methods: Mathematical and geometric analysis is performed in 2-dimensions for several hypothetical calcaneal osteotomies as described by the original authors. The resulting changes are calculated and compared. Results: The shape of the bone resection for the lateral closing wedge osteotomy does not result in significantly different final calcaneal architectures. Both techniques studied result in the same amount of calcaneal shortening and deformity correction. However, when lateral calcaneal wedge resection is combined with lateral translation of the tuberosity for additional deformity correction, more calcaneal shortening is seen with posteriorly directed osteotomies than those that are transverse. Conclusion: The lateral closing wedge osteotomy of the calcaneus results in correction of varus hindfoot deformity at the expense of some calcaneal shortening. Lateral translation of the tuberosity may result in additional calcaneal. The clinical effects of calcaneal shortening or medial soft tissue or nerve tethering from these different techniques are unknown and deserve further investigation. Level of Evidence: Level V, expert opinion.
AB - Background: A lateral closing wedge osteotomy is used for correction of varus hindfoot deformities. Since its original description, different techniques and geometries of the calcaneal bone wedge resection have been described. Even though the techniques seem similar, very different final bone architectures result from each technique, the effects of which are not known. This paper explores several of these techniques and the implications in deformity correction as well as the secondary effects of calcaneal shortening. Methods: Mathematical and geometric analysis is performed in 2-dimensions for several hypothetical calcaneal osteotomies as described by the original authors. The resulting changes are calculated and compared. Results: The shape of the bone resection for the lateral closing wedge osteotomy does not result in significantly different final calcaneal architectures. Both techniques studied result in the same amount of calcaneal shortening and deformity correction. However, when lateral calcaneal wedge resection is combined with lateral translation of the tuberosity for additional deformity correction, more calcaneal shortening is seen with posteriorly directed osteotomies than those that are transverse. Conclusion: The lateral closing wedge osteotomy of the calcaneus results in correction of varus hindfoot deformity at the expense of some calcaneal shortening. Lateral translation of the tuberosity may result in additional calcaneal. The clinical effects of calcaneal shortening or medial soft tissue or nerve tethering from these different techniques are unknown and deserve further investigation. Level of Evidence: Level V, expert opinion.
KW - biomechanics
KW - calcaneal osteotomy
KW - lateral sliding
UR - http://www.scopus.com/inward/record.url?scp=84896778983&partnerID=8YFLogxK
U2 - 10.1177/1071100713518188
DO - 10.1177/1071100713518188
M3 - Article
C2 - 24371022
AN - SCOPUS:84896778983
SN - 1071-1007
VL - 35
SP - 238
EP - 242
JO - Foot and Ankle International
JF - Foot and Ankle International
IS - 3
ER -