Abstract
When using the Evans calcaneal osteotomy for repair of a calcaneovalgus deformity,
lengthening of the lateral column of the foot is the method by which the procedure
acts to correct the deformity. Therefore, maintaining the length is a priority. In
our experience, substantial length is lost soon after surgery using the traditional
nonfixated procedure. To test this hypothesis, a retrospective study was undertaken
in which we compared the calcaneal length before and after the Evans procedures in
22 patients treated without fixation and 13 patients in whom the graft was fixated
with a small locking plate to bridge the osteotomy and reduce the compressive forces
on the graft. Within the first 10 days after surgery, the increase in calcaneal length
from the preoperative length was 6.3 mm in the nonfixated group and 6.8 mm in the
fixated group (p = .54 for the 0.5-mm difference). At 12 weeks after surgery, the mean amount of shortening
from the value observed at 1 week was 2.45 (range 0 to 6) mm in the nonfixated group
and 1.0 (range 0 to 3) mm in the internal fixation group (p = .48). Also, at 12 weeks, distal calcaneal migration or dorsal anterior calcaneal
displacement of more than 3 mm occurred in 5 patients (23%) in the nonfixated group
and 1 patient (8%) in the fixated group (p = .04). Our results suggest that locking plates do preserve the correction obtained
with the Evans calcaneal osteotomy.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 24, 2013
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
