title: Implications of subtalar joint anatomic variation in calcaneal lengthening osteotomy.
abstract: The purpose of this study was to identify the percentage of individuals with distinct anterior and middle calcaneal facets. Calcaneal lengthening osteotomy, as popularized by Mosca, is extra-articular, with its site being the interval between the anterior and middle calcaneal facets. For individuals without a distinct anterior and middle facet, the subtalar joint must be violated to perform this operation. The authors studied 1,056 calcanei in 528 human cadavers from the Hamann-Todd Osteology Collection at the Cleveland Museum of Natural History. Findings were categorized using the Bunning and Barnett classification of subtalar facet configuration. Type A was found in 389 calcanei (37%), type B in 480 calcanei (46%), and type C in only two calcanei. Transitional type was found in 122 calcanei (12%). There was no anterior facet in 61 calcanei (6%). Asymmetry was found in 51 cadavers (10%). Most calcaneal lengthening osteotomies will occur intra-articularly, which may affect clinical results.
authors.affiliation: University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA. aragab@orthopedics.umsmed.edu
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Ragab
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stewart
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Cooperman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001852:Bone Lengthening / Q000379:methods*; D002102:Cadaver; D002111:Calcaneus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013380:Subtalar Joint / Q000033:anatomy & histology* / Q000502:physiology