Charlie R J Jowett1, David Rodda2, Anish Amin3, Anthony Bradshaw4, Harvinder S Bedi5. 1. Foot & Ankle Fellow, The Alfred Hospital, Commercial Road, Melbourne, VIC, Australia. Electronic address: charliejowett@hotmail.com. 2. Orthopaedic Surgery, BoxHill Public Hospital, 8 Arnold Street, Melbourne 3128, VIC, Australia. 3. Orthopaedic Surgery, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland. 4. Orthopaedic Surgery, 9 Gormly Avenue, Wagga Wagga 2650, NSW, Australia. 5. OrthoSport Victoria, 4/32 Erin Street, Richmond, VIC, Australia.
Abstract
BACKGROUND: A cadaveric and clinical study was performed to assess whether a minimally invasive technique is a potentially safer alternative compared to a calcaneal osteotomy through an open lateral approach. METHODS: Cadaveric: A minimally invasive calcaneal osteotomy (MICO) was performed on nine cadaveric specimens. These were examined to identify any nerve injury and to quantify the displacement achieved with the osteotomy. Clinical: A retrospective review of a sequential case series of medializing MICO's performed by the senior author between October 2011 and November 2014 was undertaken. RESULTS: Cadaveric: Neurological structures remained uninjured in all specimens. The distance of the sural nerve and the main trunk of the tibial nerve to the superior limb of the oblique osteotomy was 6.2±4.8mm (range 0-14mm) and 7.3±3.6mm (range 4-12mm), respectively. The mean coronal shift achieved was 16.7±3.4mm (range 12-21mm). Clinical: The senior author carried out 35 medializing MICO procedures. Radiological and clinical union occurred in all 35 cases (100%). There were no neurovascular or wound complications. CONCLUSION: Minimally invasive calcaneal osteotomy offers a safe alternative to an open procedure with promising clinical results.
BACKGROUND: A cadaveric and clinical study was performed to assess whether a minimally invasive technique is a potentially safer alternative compared to a calcaneal osteotomy through an open lateral approach. METHODS: Cadaveric: A minimally invasive calcaneal osteotomy (MICO) was performed on nine cadaveric specimens. These were examined to identify any nerve injury and to quantify the displacement achieved with the osteotomy. Clinical: A retrospective review of a sequential case series of medializing MICO's performed by the senior author between October 2011 and November 2014 was undertaken. RESULTS: Cadaveric: Neurological structures remained uninjured in all specimens. The distance of the sural nerve and the main trunk of the tibial nerve to the superior limb of the oblique osteotomy was 6.2±4.8mm (range 0-14mm) and 7.3±3.6mm (range 4-12mm), respectively. The mean coronal shift achieved was 16.7±3.4mm (range 12-21mm). Clinical: The senior author carried out 35 medializing MICO procedures. Radiological and clinical union occurred in all 35 cases (100%). There were no neurovascular or wound complications. CONCLUSION: Minimally invasive calcaneal osteotomy offers a safe alternative to an open procedure with promising clinical results.