Calcaneal
osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot
deformity. It has static, architectural and dynamic effects, reorienting the tuberosity action point of the digastric muscle formation of the sural triceps and plantar aponeurosis. Calcaneal
osteotomies vary in location, form and displacement, but can be categorized as tuberosity
osteotomy, acting on talar position, and cervical
osteotomy, acting on Chopart joint-line orientation. We here describe the 3 main calcaneal
osteotomies we use for hindfoot
deformity: talar varus/valgus, valgus
flatfoot, and midfoot abductus/adductus. In each case, we describe our technique, resulting from our responses to the difficulties we have had to deal with: medializing
osteotomy: performed percutaneously to limit skin complications, and easily associated to cervical calcaneal
osteotomy to manage valgus
flatfoot; Hintermann cervical adduction
osteotomy: providing excellent angular correction, while conserving a medial cortical hinge; lateralizingosteotomy: performed on a medial approach, to enhance translation capacity and prevent the acute
tarsal tunnel syndrome with which we have been otherwise confronted. Correcting
foot deformities involves complex, multi-dimensional, multi-tissue surgery that is risky as it concerns a segment with terminal vascularization. The present three techniques need to be mastered, as they are usually associated to other tendon and/or ligament reconstruction procedures, and
tourniquet time is limited. LEVEL OF EVIDENCE: V; expert opinion.