title: The effects of medial and lateral displacement calcaneal osteotomies on ankle and subtalar joint pressure distribution.
abstract: We compared the pressure distribution in the ankle and posterior facet of the subtalar joint following 1 cm medial and lateral displacement calcaneal osteotomies to the pressure distribution in the intact foot. Six cadaver specimens were loaded in neutral alignment while pressure measurements were recorded. A 1-cm medial displacement osteotomy shifted the average center of force in the ankle 1.0 mm medially (p = 0.36) while a lateral displacement osteotomy shifted the center of force 1.1 mm laterally (p = 0.42). There was also a slight shift in the percentage of pressure toward the side of the talus to which the calcaneus was shifted. For the lateral displacement osteotomy, the pressure increased 4.0% in the lateral-most quadrant (p = 0.05), while the medial osteotomy increased the pressure 1.3% in the medial quadrant (p = 0.30). In the subtalar joint, a medial displacement osteotomy shifted the pressure distribution slightly medially (5.9%, p = 0.06) and more anteriorly (9.6%, p = 0.02) while the distribution was shifted laterally (5.9%, p = 0.17) and anteriorly (5.6%, p = 0.03) with a lateral displacement osteotomy. These shifts of percentage of pressure between quadrants of the joints were slight-less than 5% in the ankle and less than 10% in the subtalar joint. Significant translation of the calcaneal tuberosity appears to have only a small effect on pressure distribution in the ankle and posterior facet of the subtalar joint in a weighted cadaver model.
authors.affiliation: Department of Orthopedics, University of Utah School of Medicine, Salt Lake City 84132, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Davitt
authors.forename: T C
authors.initials: TC
authors.lastname: Beals
authors.forename: K N
authors.initials: KN
authors.lastname: Bachus
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D002102:Cadaver; D002111:Calcaneus / Q000601:surgery*; D005530:Foot Deformities / Q000601:surgery; D006801:Humans; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011312:Pressure; D012107:Research Design; D013380:Subtalar Joint / Q000503:physiopathology*