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Journal of the American Podiatric Medical Association
Volume 95 Number 1 53-59 2005
Copyright © 2005 American Podiatric Medical Association

Double Calcaneal Osteotomy

Realignment Considerations in Eight Patients

Alan R. Catanzariti, DPM *, Robert W. Mendicino, DPM *, Glenda L. King, DPM * and Brian Neerings, DPM *

* Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh.

Corresponding author: Alan R. Catanzariti, DPM, Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, 4800 Friendship Ave, North Tower, First Floor, Pittsburgh, PA 15224.

Abstract

Posterior calcaneal displacement and anterior calcaneal distraction osteotomies have been recommended for surgical management of flexible flatfoot deformity. We combined these procedures for surgical management of adolescent flatfoot and late stage II posterior tibial tendon dysfunction in the adult. Lateral column distraction has been shown to reduce rearfoot valgus and forefoot abduction by stabilizing the midtarsal joint. Posterior calcaneal displacement osteotomy, which results in medial translation of the tuberosity, converts the posterior muscle group from an everter to an inverter. A supinatory moment, therefore, is created about the subtalar joint axis, which results in supination during the midstance phase of gait. These procedures may be considered when calcaneal valgus, forefoot abduction, and midtarsal joint instability are clinically significant. We also include rearfoot alignment radiographs, long leg calcaneal axial radiographs, and malleolar valgus indices to further evaluate alignment of the foot, ankle, and leg. Ideal realignment is achieved when the heel is vertical in resting calcaneal stance position, the forefoot is parallel to the rearfoot in the frontal plane, and the medial column is stabilized, with elimination of forefoot abduction. (J Am Podiatr Med Assoc 95(1): 53–59, 2005)






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Copyright © 2005 by the American Podiatric Medical Association.