Cargando…

Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study

CATEGORY: Hindfoot; Hindfoot INTRODUCTION/ PURPOSE: Medial displacement calcaneal osteotomy (MDCO) is routinely used to correct hindfoot valgus in flexible pes planovalgus deformities. Classically MDCO was described through a lateral heel oblique incision with soft tissue dissection and the use of s...

Descripción completa

Detalles Bibliográficos
Autores principales: Salameh, Motasem, Hsu, Raymond Y., Abousayed, Mostafa, Blankenhorn, Brad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947680/
http://dx.doi.org/10.1177/2473011423S00017
_version_ 1784892611895492608
author Salameh, Motasem
Hsu, Raymond Y.
Abousayed, Mostafa
Blankenhorn, Brad
author_facet Salameh, Motasem
Hsu, Raymond Y.
Abousayed, Mostafa
Blankenhorn, Brad
author_sort Salameh, Motasem
collection PubMed
description CATEGORY: Hindfoot; Hindfoot INTRODUCTION/ PURPOSE: Medial displacement calcaneal osteotomy (MDCO) is routinely used to correct hindfoot valgus in flexible pes planovalgus deformities. Classically MDCO was described through a lateral heel oblique incision with soft tissue dissection and the use of sagittal saw. Recently, minimally invasive surgical (MIS) techniques have gained popularity among foot and ankle surgeons, with the aim to reduce wound complications and postoperative pain and swelling. MIS calcaneal osteotomy was reported to be safe and effective as compared to open techniques. The aim of this cadaveric study was to compare the degree of deformity correction (coronal calcaneal displacement) using MIS vs open MDCO. METHODS: Eight matched pairs foot and ankle cadaveric specimen were used. All specimens were checked radiographically for any previous foot and ankle operations or deformities. For each pair, one foot (right or left) was randomly assigned to either open or MIS MDCO. After the completion of osteotomy, the calcaneal tuberosity was maximally displaced medially and fixed with 2 mm wire. The displacement was measured manually using a flexible metric ruler. All osteotomies and manual measurement was done by the same Orthopaedic surgeon. Displacement was measured on standardized axial calcaneal radiographs by three blinded foot and ankle Orthopaedic surgeons independently using an image processing software with standard scaling for magnification. The displacement was measured laterally on the anterior body fragment and medially on the posterior tuberosity fragment Figures 1. Data was compared using the Wilcoxon-Mann-Whitney U test with the P value of < 0.05 considered significant. RESULTS: Five right and three left ankles underwent MIS osteotomy. On manual measurement the mean medial displacement was 7.87 mm and 8.66 mm for MIS and open technique respectively P=0.21). On radiographs, on medial measurements the average displacement of MIS osteotomy was 5.83 mm compared to 6.36 mm for the open group with a P value of 0.34. On lateral measurements the average displacement of MIS osteotomy was 5.94 mm compared to 6.17 mm for the open group with a P value of 0.67. CONCLUSION: This cadaveric study reported comparable coronal displacement using MIS vs open techniques for medical displacement calcaneal osteotomy. MIS calcaneal osteotomy offers a reliable alternative to open techniques with the potential advantages of lower wound related complications.
format Online
Article
Text
id pubmed-9947680
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-99476802023-02-24 Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study Salameh, Motasem Hsu, Raymond Y. Abousayed, Mostafa Blankenhorn, Brad Foot Ankle Orthop Article CATEGORY: Hindfoot; Hindfoot INTRODUCTION/ PURPOSE: Medial displacement calcaneal osteotomy (MDCO) is routinely used to correct hindfoot valgus in flexible pes planovalgus deformities. Classically MDCO was described through a lateral heel oblique incision with soft tissue dissection and the use of sagittal saw. Recently, minimally invasive surgical (MIS) techniques have gained popularity among foot and ankle surgeons, with the aim to reduce wound complications and postoperative pain and swelling. MIS calcaneal osteotomy was reported to be safe and effective as compared to open techniques. The aim of this cadaveric study was to compare the degree of deformity correction (coronal calcaneal displacement) using MIS vs open MDCO. METHODS: Eight matched pairs foot and ankle cadaveric specimen were used. All specimens were checked radiographically for any previous foot and ankle operations or deformities. For each pair, one foot (right or left) was randomly assigned to either open or MIS MDCO. After the completion of osteotomy, the calcaneal tuberosity was maximally displaced medially and fixed with 2 mm wire. The displacement was measured manually using a flexible metric ruler. All osteotomies and manual measurement was done by the same Orthopaedic surgeon. Displacement was measured on standardized axial calcaneal radiographs by three blinded foot and ankle Orthopaedic surgeons independently using an image processing software with standard scaling for magnification. The displacement was measured laterally on the anterior body fragment and medially on the posterior tuberosity fragment Figures 1. Data was compared using the Wilcoxon-Mann-Whitney U test with the P value of < 0.05 considered significant. RESULTS: Five right and three left ankles underwent MIS osteotomy. On manual measurement the mean medial displacement was 7.87 mm and 8.66 mm for MIS and open technique respectively P=0.21). On radiographs, on medial measurements the average displacement of MIS osteotomy was 5.83 mm compared to 6.36 mm for the open group with a P value of 0.34. On lateral measurements the average displacement of MIS osteotomy was 5.94 mm compared to 6.17 mm for the open group with a P value of 0.67. CONCLUSION: This cadaveric study reported comparable coronal displacement using MIS vs open techniques for medical displacement calcaneal osteotomy. MIS calcaneal osteotomy offers a reliable alternative to open techniques with the potential advantages of lower wound related complications. SAGE Publications 2023-02-21 /pmc/articles/PMC9947680/ http://dx.doi.org/10.1177/2473011423S00017 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Salameh, Motasem
Hsu, Raymond Y.
Abousayed, Mostafa
Blankenhorn, Brad
Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title_full Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title_fullStr Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title_full_unstemmed Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title_short Minimally invasive Vs open medial displacement calcaneal osteotomy. A cadaveric study
title_sort minimally invasive vs open medial displacement calcaneal osteotomy. a cadaveric study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947680/
http://dx.doi.org/10.1177/2473011423S00017
work_keys_str_mv AT salamehmotasem minimallyinvasivevsopenmedialdisplacementcalcanealosteotomyacadavericstudy
AT hsuraymondy minimallyinvasivevsopenmedialdisplacementcalcanealosteotomyacadavericstudy
AT abousayedmostafa minimallyinvasivevsopenmedialdisplacementcalcanealosteotomyacadavericstudy
AT blankenhornbrad minimallyinvasivevsopenmedialdisplacementcalcanealosteotomyacadavericstudy