Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series

Background: Calcaneofibular impingement is characterized by lateral hindfoot pain and is commonly resulting from calcaneal fracture malunion or severe flatfoot deformity. Lateral calcaneal wall decompression has been used successfully to relieve pain in patients who have calcaneofibular impingement....

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Main Authors: Jay M. Levin MD, MBA, James K. DeOrio MD
Format: Article
Language:English
Published: SAGE Publishing 2020-10-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011420953793
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author Jay M. Levin MD, MBA
James K. DeOrio MD
author_facet Jay M. Levin MD, MBA
James K. DeOrio MD
author_sort Jay M. Levin MD, MBA
collection DOAJ
description Background: Calcaneofibular impingement is characterized by lateral hindfoot pain and is commonly resulting from calcaneal fracture malunion or severe flatfoot deformity. Lateral calcaneal wall decompression has been used successfully to relieve pain in patients who have calcaneofibular impingement. However, in cases of severe impingement and hindfoot valgus, lateral wall excision may leave only a small remnant of calcaneal bone for weightbearing and can lead to chronic heel pain. We describe a surgical technique using a medial displacement calcaneal osteotomy (MDCO) combined with a lateral wall exostectomy and report on the outcomes from our series of patients. Methods: Retrospective study of a single surgeon’s patients was done from 2010 to 2020 who underwent medial slide calcaneal osteotomy and lateral wall exostectomy for calcaneofibular impingement. Descriptive statistics were used to summarize patient characteristics. Our study included 9 patients, 6 females and 3 males, with a mean age of 59 years (range: 19-77) and a mean follow-up of 62 weeks (range: 6-184). Results: Five had an Achilles split approach, 2 had an oblique lateral approach, and 1 had an extensile lateral approach. Patients achieved radiographic relief of impingement and improvement in pain. Minor skin and soft tissue complications occurred in 3 patients, all of which were associated with laterally based incisions, and all resolved after a 10-day course of oral antibiotics. No major complications, emergency department visits, or readmissions occurred. Conclusions: MDCO and lateral wall exostectomy was a safe and effective treatment for severe calcaneofibular impingement. Level of Evidence: Level IV, retrospective case series.
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spelling doaj.art-b4b6ee8ffdc4435ea4d0eb7935493e0e2022-12-21T23:04:53ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142020-10-01510.1177/2473011420953793Surgical Technique for Management of Severe Calcaneofibular Impingement: Case SeriesJay M. Levin MD, MBA0James K. DeOrio MD1 Department of Orthopaedic Surgery, , Durham, NC, USA Department of Orthopaedic Surgery, , Durham, NC, USABackground: Calcaneofibular impingement is characterized by lateral hindfoot pain and is commonly resulting from calcaneal fracture malunion or severe flatfoot deformity. Lateral calcaneal wall decompression has been used successfully to relieve pain in patients who have calcaneofibular impingement. However, in cases of severe impingement and hindfoot valgus, lateral wall excision may leave only a small remnant of calcaneal bone for weightbearing and can lead to chronic heel pain. We describe a surgical technique using a medial displacement calcaneal osteotomy (MDCO) combined with a lateral wall exostectomy and report on the outcomes from our series of patients. Methods: Retrospective study of a single surgeon’s patients was done from 2010 to 2020 who underwent medial slide calcaneal osteotomy and lateral wall exostectomy for calcaneofibular impingement. Descriptive statistics were used to summarize patient characteristics. Our study included 9 patients, 6 females and 3 males, with a mean age of 59 years (range: 19-77) and a mean follow-up of 62 weeks (range: 6-184). Results: Five had an Achilles split approach, 2 had an oblique lateral approach, and 1 had an extensile lateral approach. Patients achieved radiographic relief of impingement and improvement in pain. Minor skin and soft tissue complications occurred in 3 patients, all of which were associated with laterally based incisions, and all resolved after a 10-day course of oral antibiotics. No major complications, emergency department visits, or readmissions occurred. Conclusions: MDCO and lateral wall exostectomy was a safe and effective treatment for severe calcaneofibular impingement. Level of Evidence: Level IV, retrospective case series.https://doi.org/10.1177/2473011420953793
spellingShingle Jay M. Levin MD, MBA
James K. DeOrio MD
Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
Foot & Ankle Orthopaedics
title Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
title_full Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
title_fullStr Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
title_full_unstemmed Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
title_short Surgical Technique for Management of Severe Calcaneofibular Impingement: Case Series
title_sort surgical technique for management of severe calcaneofibular impingement case series
url https://doi.org/10.1177/2473011420953793
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