title: Effects of Medial Displacement Calcaneal Osteotomy and Calcaneal Z Osteotomy on Subtalar Joint Pressures: A Cadaveric Flatfoot Model.
abstract: Medial displacement calcaneal osteotomies have been shown to be successful in the surgical management of adult acquired flatfoot, in particular, stage 2 deformity. Classically, the medial displacement calcaneal osteotomy technique has been performed. However, a calcaneal Z osteotomy has been more recently described and applied in the surgical management of flatfoot deformity. Although the potential advantages of the calcaneal Z technique have been reported, data on its effect on the subtalar joint are lacking. A validated flatfoot model was induced in 8 cadaveric feet that had been randomly assigned to either medial displacement calcaneal osteotomy (n = 4) or calcaneal Z osteotomy (n = 4). The feet were loaded through the tibia with a constant ground reaction force of 400 N, with a simultaneous increase in the Achilles tendon force to 300 or 500 N. The subtalar joint pressures were recorded before and after osteotomy. We did not detect any statistically significant differences between the 2 techniques in terms of their effects on subtalar joint pressure.
authors.affiliation: PGY-5 Orthopaedic Resident, Department of Orthopaedics and Rehabilitation, Penn State Hershey Medical Center, Hershey, PA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Patrick
authors.affiliation: Assistant Professor, Department of Orthopaedics, Penn State College of Medicine.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Lewis
authors.affiliation: Research Engineering Specialist, Division of Musculoskeletal Science, Penn State College of Medicine, Hershey, PA.
authors.forename: Evan P
authors.initials: EP
authors.lastname: Roush
authors.affiliation: Senior Instructor, Department of Public Health Science, Penn State College of Medicine, Hershey, PA.
authors.forename: Allen R
authors.initials: AR
authors.lastname: Kunselman
authors.affiliation: Assistant Professor, Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Penn State Hershey Medical Center, Hershey, PA. Electronic address: jcain1@hmc.psu.edu.
authors.forename: Jarrett D
authors.initials: JD
authors.lastname: Cain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002111:Calcaneus / Q000601:surgery*; D005260:Female; D005413:Flatfoot / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D010027:Osteotomy / Q000379:methods*; D013380:Subtalar Joint / Q000503:physiopathology; D055815:Young Adult
keywords: MDCO; calcaneus; hindfoot varus; joint pressure; pes valgus