Review of Calcaneal Osteotomies Fixed With a Calcaneal Slide Plate

Abstract

Background: The calcaneal slide osteotomy is a common procedure used for the surgical correction of heel varus and valgus deformities. A variety of fixation methods exist including screws and plates. The literature shows a high rate of hardware prominence with screws leading to subsequent removal of hardware. Few studies have examined the use of plates for fixation of a calcaneal osteotomy. The purpose of this study was to assess outcomes following fixation of a calcaneal osteotomy with a calcaneal slide plate. Methods: This is a retrospective consecutive case series of all patients who underwent either a medial or lateral calcaneal slide osteotomy using the specialized calcaneal slide plate between September 2013 and December 2018 by a single surgeon. The primary outcome measures were the rate of hardware removal, healing of the calcaneal osteotomy, and any associated complications such as infection or incision healing delays. Patient baseline demographics and procedure-related data were recorded. The minimum follow-up was 4 months. A total of 81 procedures were performed using this calcaneal slide plate. Results: All of the patients had one or more additional procedures at the same time as the calcaneal osteotomy. All of the calcaneal osteotomies healed without displacement. Only 1 patient (1.2%) returned to the operating room and had removal of the calcaneal slide plate, which was after osteotomy union for an infected wound. There were no cases of hardware failure or removal due to it being symptomatic. Conclusion: A specialized calcaneal slide plate was an effective fixation device for both medial and lateral calcaneal slide osteotomies for a variety of foot and ankle conditions. The union rate was 100% and none of the patients had hardware symptoms, which is an improvement on published reports of symptomatic hardware after calcaneal slide osteotomy. Level of Evidence: Level IV, retrospective case series.

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

“…Fortunately, nonunion at the subtalar joint was not evident. The authors' experience is consistent with that reported in the literature; the number and diameter of the screws inserted do not influence the fusion rate [36][37][38].…”

Effectiveness of calcaneal osteotomy in surgical treatment of foot conditions: A Prisma statement guidelines compliant systematic review

“…21 Due to the large number of studies in the current literature describing foot malalignment surgery problems and evaluating various techniques with theoretical instructions for performing various types of calcaneal osteotomies, the reports recognise heterogeneity in the site of the calcaneal osteotomy that suggests the choice is based on the orthopaedic surgeon's preference, simplicity or other local factors in the case of more complicated reconstructions. 5,22 In fact, it was identified that most of these foot problems were managed through a lateral approach, applying screws, a lateral plate or transfer of muscles, which are safe techniques with good radiographic and clinical results which are satisfactory in most of the patients. 13,14,[16][17][18][19][20] The majority of these scientific studies displayed adequately performed calcaneal osteotomy in foot surgery through a lateral approach as an excellent technique for the reparation of various foot malalignments.…”

“…Due to the large number of studies in the current literature describing foot malalignment surgery problems and evaluating various techniques with theoretical instructions for performing various types of calcaneal osteotomies, the reports recognise heterogeneity in the site of the calcaneal osteotomy that suggests the choice is based on the orthopaedic surgeon's preference, simplicity or other local factors in the case of more complicated reconstructions 5,22 …”

Incidence of Lateral Prominence Pain Following Open Medial Displacement Calcaneal Osteotomy and the Efficacy of Crushplasty as a Preventive Technique

“…Interestingly, this rate is consistent with reported rates of painful hardware removal of the lateral plate used for MDCO, which ranges from 0% to 21.4%. 1,6,12 This suggests that lateral calcaneal wall irritation symptoms are significant enough to seek repeat surgery in order to alleviate pain and discomfort. Therefore, lateral prominence pain due to bony step-off should be considered a complication after MDCO with a lateral oblique incision.…”

“…3,4,7,8,14,17 This surgical procedure shifts the posterior calcaneus medially, which functionally realigns the axial vector of the Achilles and redistributes weightbearing load of the foot. 2,5,11 Although there are several variations in operative techniques, 1,6,9,12,15 an oblique lateral approach followed by single or double compression screw osteotomy fixation is most commonly employed. 4,16 Because of the nature of the displacement osteotomy, the formation of a bony step-off along the lateral calcaneal wall after osteotomy fixation is inevitable.…”