The Contribution of the Medial Calcaneal Osteotomy to the Correction of Flatfoot Deformities

Abstract

In the flatfoot, loading of the Achilles tendon increases the deformity. Medial calcaneal osteotomy significantly decreases the arch-flattening effect of this tendon and therefore limits the potential increase of the deformity.

Subtalar Joint Axis in Patients With Symptomatic Peritalar Subluxation Compared to Normal Controls

“…A medializing calcaneal osteotomy will bring the tuberosity into a corrected varus position, however if the joint angle is not corrected this may be insufficient to maintain the soft tissue reconstruction. 3,9,13 A lateral column lengthening would abduct the midfoot but also would not address the malalignment of the posterior facet. This may create a compensatory deformity of hindfoot valgus and midfoot adduction that may cause altered loading of the foot.…”

Optimal Position of the Heel Following Reconstruction of the Stage II Adult-Acquired Flatfoot Deformity

“…15 Current biomechanical and clinical outcomes literature has shown that the MCO can be used to restore foot alignment, decrease load on the medial arch, normalize force at the talonavicular joint, re-position the Achilles tendon to function as a heel inverter, and improve patient outcomes. 1,9,12,14,19–22,25,26 …”

“…A commonly cited amount of intraoperative medial displacement is 10 mm, and one biomechanical study has supported this amount of heel translation. 1,2,9,11,14,19,20,22,26 However, because patients present preoperatively with different severities of hindfoot deformity, postoperative hindfoot alignments can vary significantly with the same amount of heel slide. In addition, difficulties in assessing hindfoot alignment in the operating room may cause the amount of heel slide performed to vary among surgeons.…”

Comparison of Lateral Opening Wedge Calcaneal Osteotomy and Medial Calcaneal Sliding-opening Wedge Cuboid-closing Wedge Cuneiform Osteotomy for Correction of Planovalgus Foot Deformity in Children

“…However, the mechanism of action of calcaneal-cuboid-cuneiform osteotomy is as follows. First, to address a valgus deformity of the heel, medial shifting of the mechanical pull of the tendon will eliminate the negative effect of the Achilles tendon on the planovalgus (8). Second, to address a forefoot varus deformity, a cuneiform plantar closingwedge osteotomy will restore the normal talar-first metatarsal angle.…”