Biomechanical Results of Percutaneous Calcaneal Osteotomy using Two Different Osteotomy Designs

CATEGORY: Hindfoot INTRODUCTION/PURPOSE: Percutaneous osteotomy of calcaneus has been proposed to reduce the complication rate and became more and more popular. The bone cut can be performed as a straight or chevron-like (V) osteotomy using a Shannon burr. Comparative studies of straight or V- osteotomy as like as one or two screws in percutaneous calcaneal osteotomies are missing in the literature METHODS: The straight osteotomy (9 fresh-frozen specimens) and V- osteotomy (9fresh frozen specimens) was performed and the calcaneal tuberosity was moved 10 mm medially and slightly rotated. One 6,5 mm cancellous compression screw was used for osteosynthesis. Specimens were preconditioned with 100N over 100 cycles. The force was increased after every 100N by 100N from 200 to 500N. This was followed by cyclic loading with 600N for 500 cycles. RESULTS: Despite the higher mean values of the group with V osteotomy, no significant difference was registered between the two groups regarding the stiffness at all force levels. A significant higher failure rate was observed in the group with straight osteotomy. CONCLUSION: The moderate correlation of bone density and stiffness in the V-group, and significantly lower failure rate with no secondary dislocation in fluoroscopy indicates the superiority of the V-osteotomy in the present study. Whether the demonstrated advantages can be reflected in clinical practice should be investigated in further studies.