title: [Joint-preserving osteotomy for calcanean malunions].
abstract: BACKGROUND
  Calcaneal malunions lead to a considerable loss of global foot function through the loss of the physiological hindfoot lever arm, bony and soft tissue impingement, and involvement of the subtalar joint. In the majority of cases correction of the malunion has to be combined with subtalar fusion because of a rapid development of posttraumatic subtalar arthritis.
  
  
  METHODS
  Joint-preserving corrective osteotomy may be considered in carefully selected patients with intact joint cartilage, sufficient bone quality, and good patient compliance. This is the case in extra-articular malunion and intra-articular malunion with displacement of the complete posterior facet of the subtalar joint.
  
  
  RESULTS
  While respecting the criteria for indications, overall good functional results could be achieved in two clinical studies on this subject. Only 1 of the 26 reported patients required a secondary subtalar fusion. In case of development of subtalar arthritis a secondary in situ fusion of the subtalar joint can be performed on a corrected hindfoot with good prospects.
  
  
  CONCLUSIONS
  In carefully selected cases of malunited intra-articular calcaneal fractures, joint-preserving osteotomy is an alternative to corrective subtalar fusion.
authors.affiliation: UniversitätsCentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum "Carl Gustav Carus" der TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland, stefan.rammelt@uniklinikum-dresden.de.
authors.forename: S
authors.initials: S
authors.lastname: Rammelt
authors.forename: W
authors.initials: W
authors.lastname: Schneiders
authors.forename: H
authors.initials: H
authors.lastname: Zwipp
mesh_terms: D002111:Calcaneus / Q000293:injuries* / Q000601:surgery*; D050723:Fractures, Bone / Q000175:diagnosis / Q000601:surgery*; D017759:Fractures, Malunited / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D059351:Organ Sparing Treatments / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome