Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques
Introduction: Joint preserving surgery for flatfoot reconstruction utilizes correction of bony malalignment and medial soft tissue reconstruction. A medial displacement calcaneal osteotomy (MDCO) can be an essential adjunct to deformity correction and good patient outcomes. Our cadaveric study compa...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Foot & Ankle Surgery: Techniques, Reports & Cases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667396723000484 |
| _version_ | 1797400826767998976 |
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| author | Benjamin D. Umbel, DO Terrence M. Philbin, DO Dale B. Sharpe, DO Mark A. Prissel, DPM |
| author_facet | Benjamin D. Umbel, DO Terrence M. Philbin, DO Dale B. Sharpe, DO Mark A. Prissel, DPM |
| author_sort | Benjamin D. Umbel, DO |
| collection | DOAJ |
| description | Introduction: Joint preserving surgery for flatfoot reconstruction utilizes correction of bony malalignment and medial soft tissue reconstruction. A medial displacement calcaneal osteotomy (MDCO) can be an essential adjunct to deformity correction and good patient outcomes. Our cadaveric study compares three different surgical techniques utilizing two cannulated screws to best maintain medial translation of the calcaneal osteotomies. Materials and methods: Fifteen above knee fresh-frozen, matched pair cadaveric specimens (30 limbs) were randomized equally to three groups. MDCO were performed on all specimens, followed by manual 10 mm translation. The groups consisted of a “simultaneous drilling,” “staggered drilling,” and a control group, which involved simultaneous drilling of only the near cortex. Following screw fixation, the calcaneal tuberosity was manually translated in a lateral direction. The loss of correction was measured in millimeters. Results: The “simultaneous” drilling group experienced the greatest mean loss of correction at 2.6 mm (range 1.37–3.48 mm). The “staggered” group showed an average loss of 1.16 mm (range 0.36–2.67 mm). The control group demonstrated the greatest maintenance of correction with a mean loss of 0.036 mm (range 0.01–0.06 mm). Conclusions: MDCO realigns the hindfoot adding support to the medial soft tissue reconstruction during flatfoot correction. Loss of initial correction may result in residual deformity and poor long-term outcomes. Our study demonstrates that simultaneous drilling of only the tuberosity near cortex prior to screw fixation was the best at maintaining osteotomy correction. Level of evidence: : Level V, Cadaveric study |
| first_indexed | 2024-03-09T02:01:15Z |
| format | Article |
| id | doaj.art-e2711e4930d14b35b5979fa81784d228 |
| institution | Directory Open Access Journal |
| issn | 2667-3967 |
| language | English |
| last_indexed | 2024-03-09T02:01:15Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Foot & Ankle Surgery: Techniques, Reports & Cases |
| spelling | doaj.art-e2711e4930d14b35b5979fa81784d2282023-12-08T04:47:25ZengElsevierFoot & Ankle Surgery: Techniques, Reports & Cases2667-39672023-01-0134100310Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniquesBenjamin D. Umbel, DO0Terrence M. Philbin, DO1Dale B. Sharpe, DO2Mark A. Prissel, DPM3OhioHealth, Columbus, OH, USAOrthopedic Foot & Ankle Center, 350 W. Wilson Bridge RD, STE 200, Worthington, OH, USAUniversity of Virginia Health Systems, Charlottesville, VA, USAOrthopedic Foot & Ankle Center, 350 W. Wilson Bridge RD, STE 200, Worthington, OH, USA; Corresponding author.Introduction: Joint preserving surgery for flatfoot reconstruction utilizes correction of bony malalignment and medial soft tissue reconstruction. A medial displacement calcaneal osteotomy (MDCO) can be an essential adjunct to deformity correction and good patient outcomes. Our cadaveric study compares three different surgical techniques utilizing two cannulated screws to best maintain medial translation of the calcaneal osteotomies. Materials and methods: Fifteen above knee fresh-frozen, matched pair cadaveric specimens (30 limbs) were randomized equally to three groups. MDCO were performed on all specimens, followed by manual 10 mm translation. The groups consisted of a “simultaneous drilling,” “staggered drilling,” and a control group, which involved simultaneous drilling of only the near cortex. Following screw fixation, the calcaneal tuberosity was manually translated in a lateral direction. The loss of correction was measured in millimeters. Results: The “simultaneous” drilling group experienced the greatest mean loss of correction at 2.6 mm (range 1.37–3.48 mm). The “staggered” group showed an average loss of 1.16 mm (range 0.36–2.67 mm). The control group demonstrated the greatest maintenance of correction with a mean loss of 0.036 mm (range 0.01–0.06 mm). Conclusions: MDCO realigns the hindfoot adding support to the medial soft tissue reconstruction during flatfoot correction. Loss of initial correction may result in residual deformity and poor long-term outcomes. Our study demonstrates that simultaneous drilling of only the tuberosity near cortex prior to screw fixation was the best at maintaining osteotomy correction. Level of evidence: : Level V, Cadaveric studyhttp://www.sciencedirect.com/science/article/pii/S2667396723000484Hindfoot alignmentAdult acquired flatfoot deformityMedial displacement calcaneus osteotomyHeel slide |
| spellingShingle | Benjamin D. Umbel, DO Terrence M. Philbin, DO Dale B. Sharpe, DO Mark A. Prissel, DPM Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques Foot & Ankle Surgery: Techniques, Reports & Cases Hindfoot alignment Adult acquired flatfoot deformity Medial displacement calcaneus osteotomy Heel slide |
| title | Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques |
| title_full | Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques |
| title_fullStr | Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques |
| title_full_unstemmed | Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques |
| title_short | Medial displacement calcaneal osteotomy: Loss of correction with varying drilling techniques |
| title_sort | medial displacement calcaneal osteotomy loss of correction with varying drilling techniques |
| topic | Hindfoot alignment Adult acquired flatfoot deformity Medial displacement calcaneus osteotomy Heel slide |
| url | http://www.sciencedirect.com/science/article/pii/S2667396723000484 |
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