Comparative Results of Percutaneous Calcaneal Osteotomy in Correction of Hindfoot Deformities

Gutteck, Natalia; Zeh, Alexander; Wohlrab, David; Delank, Karl‐Stefan

doi:10.1177/1071100718809449

Cited by 32 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with smaller cohorts found in literature, in which the observed rate of wound and soft tissue complications after percutaneous calcaneal osteotomies ranges from 0% to 6.5%. 8 , 10 …”

Section: Discussionmentioning

confidence: 99%

Complications After Percutaneous Osteotomies of the Calcaneus

deMeireles

Guzman

Nordio

et al. 2022

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

Background: Open hindfoot surgery is associated with a relatively high rate of complications, including neurovascular injuries and wound healing problems compared with percutaneous techniques. However, there is a scarcity of literature describing the outcomes of these percutaneous techniques given their relatively recent adoption. The present study aims to assess the rate of postoperative complications for 3 commonly performed percutaneous calcaneal osteotomies. Methods: One hundred eighteen patients (unilateral feet) were treated with one of 3 common percutaneous calcaneal osteotomies. Sixty-five patients (55.1%) were treated with a medializing calcaneal osteotomy for hindfoot valgus, 32 patients with a Zadek osteotomy (27.1%) for insertional Achilles tendinopathy, and 21 patients (17.8%) with a modified Dwyer osteotomy for hindfoot varus. Fisher exact test was used to assess for associations between categorical variables. Results: The mean age was 46.2 years and there was a mean follow-up of 16.1 months. The overall rate of postoperative complications was 3.4% (n = 4), and no significant differences were found between the different osteotomy types. Complications included 2 cases (1.7%) of transient neuritis, 1 case of prolonged wound drainage (0.8%), and 1 nonunion (0.8%). None of the complications were associated with any recorded preoperative comorbidity. Discussion: In this series, we found that percutaneous calcaneal osteotomies are a safe alternative method for the treatment of conditions involving the hindfoot. The rate of postoperative complications may be less when compared to the reported rates of open hindfoot correction and should be considered in patients with a traditionally high risk of developing a postoperative complication. Level of Evidence: Level IV, retrospective analysis.

show abstract

Section: Discussionmentioning

confidence: 99%

Complications After Percutaneous Osteotomies of the Calcaneus

deMeireles

Guzman

Nordio

et al. 2022

Foot & Ankle Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Line A is the landmark line and extends from the posterosuperior aspect of the calcaneal tuberosity to the plantar fascia origin according to Talusan et al 16 In this study, we adopted line A because it was the reproducible radiographic landmark line due to bony prominence of the posterosuperior aspect of the calcaneal tuberosity and the plantar fascia origin, as Sherman and Guyton 23 and Gutteck et al 7 adopted in their studies. The following parameters were measured in the sagittal plane: (1) the average perpendicular distance between the LPA and line A at its closest point, (2) the average distance from the posterosuperior of the calcaneal tuberosity to the point on line A where LPA comes the closest to line A, (3) the average distance from the plantar fascia origin to the point on line A where LPA comes the closest to line A (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…In such calcaneal osteotomies, complication rates from 5% to 28% have been reported in the literature. [4][5][6][7] The anatomic location of lateral plantar artery (LPA) makes it susceptible to iatrogenic injury during surgical procedures on the foot. 8 LPA pseudoaneurysm has been reported after calcaneal osteotomy as one of the complications.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Examination of Safe Zone to Avoid Injury of the Lateral Plantar Artery During Calcaneal Osteotomy: A Fresh Cadaveric Study

Tonogai

Tsuruo

Sairyo

2020

Foot & Ankle Specialist

View full text Add to dashboard Cite

Background: Calcaneal osteotomy are used to treat various pathologies in the correction of hindfoot deformities. But lateral plantar artery (LPA) pseudoaneurysms have been reported following calcaneal osteotomy, and LPA pseudoaneurysms may be at risk for rupture. Although the vascular structures in close proximity to calcaneal osteotomies have variable courses and branching patterns, there is little information on safe zone for LPA during calcaneal osteotomy. The aims of this study were to identify the safety zone to avoid the LPA injury during calcaneal osteotomy. Methods: Enhanced computed tomography scans of 25 fresh cadaveric feet (male, n = 13; female, n = 12; mean age 79.0 years at the time of death) were assessed. The specimens were injected with barium via the external iliac artery. Line A is the landmark line and extends from the posterosuperior aspect of the calcaneal tuberosity to the plantar fascia origin, and the perpendicular distance between the LPA and line A at its closest point was measured on sagittal images. Results: The average perpendicular distance between the LPA and line A at its closest point was 15.2 ± 2.9 mm. In 2 cases (8.0 %), the perpendicular distance between the LPA and line A at its closest point was very close, approximately 9 mm. In 18 of 25 feet (72.0%), the point where perpendicular distance from the line A to LPA is the closest was the bifurcation of one of the medial calcaneal branches from LPA, and in 7 feet in 25 feet (28.0%) feet the point where perpendicular distance from the line A to LPA is the closest was the trifurcation of LPA, medial plantar artery, and one of the medial calcaneal branches. Conclusions: Calcaneal osteotomy approximately more than 9 mm from the line A could injure the LPA in overpenetration into the medial aspect of tcalcaneal osteotomy. Completion of the osteotomy on the medial side should be performed with caution to avoid iatrogenic injury of the LPA. Levels of Evidence:: Level IV, Cadaveric study

show abstract

“…[1][2][3] Calcaneal osteotomy via a lateral or oblique incision is occasionally associated with neurovascular injury, and complication rates of 5-28% have been reported in the literature. [4][5][6][7] The anatomic location of the lateral plantar artery (LPA) makes it susceptible to iatrogenic injury during operative procedures involving the foot. 8 One of the complications reported after calcaneal osteotomy is pseudoaneurysm of the LPA.…”

Section: Introductionmentioning

confidence: 99%

Calcaneal Osteotomy “Safe Zone” for Avoiding Injury to the Lateral Plantar Artery: A Fresh Cadaveric Study

Tonogai¹,

Sairyo²,

Tsuruo³

2020

Preprint

View full text Add to dashboard Cite

Background Calcaneal osteotomy is used to correct hindfoot deformity. Pseudoaneurysms of the lateral plantar artery (LPA) have been reported following calcaneal osteotomy and are at risk of rupture. The vascular structures in close proximity to the calcaneal osteotomy have variable courses and branching patterns. However, there is little information on the “safe zone” during calcaneal osteotomy. This study aimed to identify the safe zone that avoids LPA injury during calcaneal osteotomy.Methods Enhanced computed tomography scans of 25 fresh cadaveric feet (13 male and 12 female specimens; mean age 79.0 years at time of death) were assessed. The specimens were injected with barium via the external iliac artery. A landmark line (line A) connecting the posterosuperior aspect of the calcaneal tuberosity and the origin of the plantar fascia was drawn and the shortest perpendicular distance between the LPA and line A was measured on sagittal images.Results The average perpendicular distance between the LPA and line A at its closest point was 15.2 ± 2.9 mm. In 2 feet (8.0%), the perpendicular distance between the LPA and line A at its closest point was very short (approximately 9 mm). In 18 of the 25 feet (72.0%), the point where the perpendicular distance from line A to the LPA was closest was the bifurcation of one of the medial calcaneal branches of the LPA, and in 7 feet (28.0%) the shortest perpendicular distance from line A to the LPA was the trifurcation of the LPA, medial plantar artery, and one of the medial calcaneal branches.Conclusion Calcaneal osteotomy performed more than 9 mm from line A could damage the LPA by overpenetration on the medial side. Calcaneal osteotomy on the medial side should be performed with caution to avoid iatrogenic injury to the LPA.Level of Evidence: IV, cadaveric study

show abstract

Comparative Results of Percutaneous Calcaneal Osteotomy in Correction of Hindfoot Deformities

Cited by 32 publications

References 20 publications

Complications After Percutaneous Osteotomies of the Calcaneus

Complications After Percutaneous Osteotomies of the Calcaneus

Examination of Safe Zone to Avoid Injury of the Lateral Plantar Artery During Calcaneal Osteotomy: A Fresh Cadaveric Study

Calcaneal Osteotomy “Safe Zone” for Avoiding Injury to the Lateral Plantar Artery: A Fresh Cadaveric Study

Contact Info

Product

Resources

About