Bone Graft Harvesting From the Calcaneus Using Lateral Wall Corticotomy Technique by an Osteotome

Abstract

Background: The aim of this study was to evaluate the complications following calcaneal autologous bone graft harvesting using an osteotome in patients who underwent foot and ankle surgery with follow-up of at least 1 year. Methods: In a cohort study, all consecutive patients underwent forefoot or midfoot surgeries in conjunction with harvesting bone graft from the calcaneus using lateral wall corticotomy technique by an osteotome from 2015 till 2018 were asked to follow. The outcome and morbidity were assessed by visual analogue scale (VAS) pain, numbness in territory of the sural nerve, surgical site numbness or tenderness, infection, hematoma formation, or pathologic fracture. Also any possible restrictions on wearing desired shoes were asked. Results: Totally, 50 patients (11 males, 39 females; 29 right foot, 21 left foot) with the mean age of 48.2 ± 13.8 years (range 8-66 years) were assessed. There were no major complications on donor site such as infection, hematoma formation, or pathologic fracture. The following results were seen; 90% without any pain (VAS 0/10), 96% without numbness at the incision site, 96% without point tenderness on lateral of heel, 98% without paresthesia or numbness in the sural nerve territory, and 84% were able to wear their favorite shoes. Forty-one (82%) cases said if they need another foot surgery, they would permit to harvest bone graft from their heel. Conclusions: Autologous bone graft harvesting from the calcaneus using lateral wall corticotomy technique by an osteotome could be a useful method with very low complications. Levels of Evidence: Therapeutic, level IV: cohort, case series

Tratamiento de pseudoartrosis postquirúrgica en la base del segundo metatarsiano mediante autoinjerto de calcáneo: caso clínico.

“…En este caso se colocó un autoinjerto de calcáneo del mismo pie para mantener la longitud del segmento óseo. El injerto de calcáneo es un injerto corticoesponjoso bicortical que ha sido ha sido utilizado con éxito en diferentes casos de cirugía de pie y tobillo 33,34 y cuya morbilidad asociada a la zona donante en el calcáneo parece ser bastante reducida [35][36][37] . Este injerto corticoesponjoso mantiene la cortical del calcáneo obtenida de la zona dorsal y lateral del calcáneo, por lo que no es únicamente un injerto esponjoso 38 .…”