title: An Anatomic Study of the Percutaneous Endoscopically Assisted Calcaneal Osteotomy Technique to Correct Hindfoot Malalignment.
abstract: BACKGROUND
  Open calcaneal osteotomy using traditional methods is associated with complications such as sural nerve injury and potential wound healing problems. We hypothesized that by using novel minimally invasive techniques, these potential risks could be mitigated. This anatomic cadaveric study serves to assess the safety of percutaneous endoscopically assisted calcaneal osteotomy (PECO) compared to a traditional open osteotomy technique.
  
  
  METHODS
  Anatomic safety of PECO was assessed using 8 fresh-frozen cadaver below-knee specimens. Lateral calcaneal nerve (LCN) damage was primarily noted and then secondly compared to a potential open surgical incision approach.
  
  
  RESULTS
  Only 1 of 11 LCN branches (n = 8 limbs) was transected using PECO, compared to up to 8 of 10 LCN branches (n = 6 limbs) that potentially would have been injured during open surgery.
  
  
  CONCLUSIONS
  Percutaneous endoscopically assisted calcaneal osteotomy is a minimally invasive technique that had fewer nerve injuries in this cadaveric model than traditional open surgery.
  
  
  CONCLUSIONS
  Percutaneous endoscopically assisted calcaneal osteotomy due to its less invasive nature may result in fewer neurovascular injuries relative to an open procedure.
authors.affiliation: 1 St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Veljkovic
authors.affiliation: 2 Foot and Ankle UNC Orthopaedics, Chapel Hill, NC, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Tennant
authors.affiliation: 3 University of Iowa, Iowa City, IA, USA.
authors.forename: Chamnanni
authors.initials: C
authors.lastname: Rungprai
authors.affiliation: 4 University Health Network-Toronto Western Division, Toronto, ON, Canada.
authors.forename: Kaniza Zahra
authors.initials: KZ
authors.lastname: Abbas
authors.affiliation: 5 Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
authors.forename: Phinit
authors.initials: P
authors.lastname: Phisitkul
mesh_terms: D002111:Calcaneus / Q000294:innervation / Q000601:surgery*; D004724:Endoscopy; D005530:Foot Deformities / Q000601:surgery; D006801:Humans; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D059348:Peripheral Nerve Injuries / Q000209:etiology
keywords: calcaneal osteotomies; hindfoot malalignment; lateral calcaneal nerve (LCN); open surgery; percutaneous endoscopically assisted calcaneal osteotomy (PECO)