Calcaneal Therapeutic Osteotomy

Benefits of Calcaneal Osteotomy  

The benefits of calcaneal osteotomy include:  

• Improved foot alignment 

• Reduced pain and discomfort 

• Improved range of motion 

• Enhanced foot function and mobility 

• Enhanced stability 

• Better overall quality of life  

Types of Calcaneal Osteotomy  

There are various types of calcaneal osteotomy procedures, each serving a unique purpose: 

• Medializing Calcaneal Osteotomy (MCO): This procedure is designed to correct fallen arch by repositioning the heel bone inward to realign the foot, restore a more natural arch, improve overall foot function and prevent further deterioration of the foot structure.  

• Lateralizing Calcaneal Osteotomy (LCO): This procedure is to correct abnormally high arches by shifting the heel bone to the outside in order to redistribute weight more evenly across the foot, reducing pain and enhancing stability.   

• Dwyer Osteotomy: This procedure is carried out to correct varus deformity of the heel, where the heel bone tilts inward excessively.  

• Evans Osteotomy: Lengthens the lateral side of the foot, particularly useful for correcting flatfoot deformity in children.  

The Procedure 

Calcaneal osteotomy is a detailed and carefully executed surgical procedure and involves:  

Before procedure: 

• Patient Assessment: Consultation with orthopaedic surgeon, comprehensive evaluation of the patient’s medical history, physical examination, and imaging studies (X-rays, MRI, CT scans) to determine the extent of the deformity and plan the surgery. 

• Anesthesia: The procedure is typically performed under general anesthesia or regional anesthesia (spinal or epidural), depending on the patient’s condition.  

During the procedure: 

• Skin Incision: The exact location and length of the incision depends on the type of osteotomy being performed. 

• Exposure: The soft tissues and muscles are carefully retracted to expose the calcaneus. 

• Osteotomy: Using specialized surgical tools such as oscillating saws or chisels, the surgeon makes a controlled cut through the calcaneus. The type and direction of the cut depend on the specific osteotomy being performed. 

• Shifting the Bone: The cut section of the calcaneus is carefully repositioned to achieve the desired correction.  

• Bone Graft: For some patients, bone graft may be used to fill any gaps created by the repositioning of the calcaneus to ensure stability and promote healing. 

• Securing the Bone: The repositioned calcaneus is secured in place using screws, plates, or pins. The choice of fixation depends on the specific osteotomy performed. 

• Fluoroscopy Check: The position and alignment of the bone and hardware are verified using fluoroscopy to ensure proper correction. 

• Soft Tissue Repair: The soft tissues and muscles are carefully repositioned and sutured back into place. 

• Skin Closure: The skin incision is closed using sutures or staples. A sterile dressing is applied to the surgical site.  

After the Procedure   

• Immobilization: The foot is immobilized in a cast or boot to protect the surgical site and promote healing. Non-weight-bearing or limited weight-bearing is typically required for several weeks. 

• Monitoring: The patient is monitored for any signs of complications, such as infection or nerve damage. 

• Physical Therapy: Once initial healing has occurred, physical therapy is initiated to restore strength, flexibility, and function. This includes exercises to improve range of motion and gradually increase weight-bearing.  

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