The Effect of Medial and Lateral Calcaneal Osteotomies on the Tarsal Tunnel

Bruce, Benjamin; Bariteau, Jason T.; Evangelista, Peter; Arcuri, Daniel; Sandusky, Matthew; DiGiovanni, Christopher W.

doi:10.1177/1071100713519599

Cited by 40 publications

(55 citation statements)

References 18 publications

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“…5) is performed more than 9 mm anterior to line A and overpenetrates on the medial side of the calcaneus. Our ndings also indicate that an anteriorly oriented osteotomy places the artery in greater proximity to the osteotomy line than would be the case with an osteotomy that is directed posteriorly, which is consistent with a report by Bruce et al 20 Consistent with ndings reported by both DiDomenico et al and Greene et al that both the LPA and PTA and their branches could cross the Myerson osteotomy line, 3,15 we found that at least one of the medial calcaneal branches crossed line A in all cases. These observations indicate that the medial calcaneal branches (arteries) are at risk during calcaneal osteotomy.…”

Section: Discussionsupporting

confidence: 93%

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

Tonogai¹,

Sairyo²,

Tsuruo³

2020

Preprint

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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

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Section: Discussionsupporting

confidence: 93%

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

Tonogai¹,

Sairyo²,

Tsuruo³

2020

Preprint

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“…11 In a cadaveric study using magnetic resonance imaging to assess the volume of the tarsal tunnel under varying amounts of both medial and lateral displacement of a calcaneal osteotomy, Bruce et al discovered a 14% to 21% decrease in tarsal tunnel volume dependent on the amount of shift. 3 The authors also observed a trend toward lower volumes with LCO versus medializing calcaneal osteotomies.…”

Section: Discussionmentioning

confidence: 89%

Neurologic Deficit Associated With Lateralizing Calcaneal Osteotomy for Cavovarus Foot Correction

VanValkenburg¹,

Hsu

Palmer

et al. 2016

Foot Ankle Int.

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“…Osteotomies of the calcaneus performed through a lateral approach may increase risk to the medial neurovascular structures through direct injury from penetration of the medial cortex, reduction in tarsal tunnel volume from the resulting shift, or compression from the inferior flexor retinaculum. 2,24 Reports of the latter 2 complications are scarce. In addition, complications involving nerve entrapment would not be expected to be different with MIS vs open techniques.…”

Section: Complicationsmentioning

confidence: 99%

Minimal Incision/Minimally Invasive Medializing Displacement Calcaneal Osteotomy

Sherman

Guyton

2017

Foot Ankle Int.

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The Effect of Medial and Lateral Calcaneal Osteotomies on the Tarsal Tunnel

Abstract: These findings provide surgeons with clinical evidence in support of performing a prophylactic tarsal tunnel release for patients undergoing lateralizing calcaneal osteotomies.

Cited by 40 publications

References 18 publications

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

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

Neurologic Deficit Associated With Lateralizing Calcaneal Osteotomy for Cavovarus Foot Correction

Minimal Incision/Minimally Invasive Medializing Displacement Calcaneal Osteotomy

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