Plantar fascia release and calcaneal slide osteotomy are often components of the surgical management for cavovarus deformities of the foot. In this setting, plantar fascia release has traditionally been performed through an incision over the medial calcaneal tuberosity, and the calcaneal osteotomy through a lateral incision. Two separate incisions can potentially increase the operative time and morbidity. The purpose of the present study was threefold: to describe the operative technique, use cadaveric dissection to analyze whether a full release of the plantar fascia was possible through the lateral incision, and examine the proximity of the medial neurovascular structures to both the plantar fascia release and calcaneal slide osteotomy when performed together. In our cadaveric dissections, we found that full release of the plantar fascia is possible through the lateral incision with no obvious damage to the medial neurovascular structures. We also found that the calcaneal branch of the tibial nerve reliably crossed the osteotomy in all specimens. We have concluded that both the plantar fascia release and the calcaneal osteotomy can be safely performed through a lateral incision, if care is taken when completing the calcaneal osteotomy to ensure that the medial neurovascular structures remain uninjured.
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- Evaluation of the cavus foot for orthopedic treatment.Clin Orthop. 1983; 181: 52-63
- Surgical management and treatment algorithm for the subtle cavovarus foot.Foot Ankle Int. 2010; 31: 1057-1063
- Cavovarus foot reconstruction.Foot Ankle Clin. 2009; 14: 471-487
- Long-term results of reconstruction for treatment of a flexible cavovarus foot in Charcot-Marie-Tooth disease.J Bone Joint Surg Am. 2008; 90: 2631-2642
- Adult cavovarus foot.J Am Acad Orthop Surg. 2005; 13: 302-315
- Surgical treatment of plantar fasciitis.Clin Orthop. 1984; 186: 202-204
- Midfoot osteotomies for the cavus foot.Clin Podiatr Med Surg. 2005; 22: 247-264
- An anatomic analysis of endoscopic plantar fascia release.Foot Ankle Int. 1995; 16: 552-558
- Endoscopic plantar fascia release: an anatomical study.Foot Ankle Int. 1995; 16: 719-723
- Plantar fasciitis: evaluation and treatment.J Am Acad Orthop Surg. 2008; 16: 338-346
- Surgical correction of rigid equinovarus contracture utilizing extensive soft tissue release.Clin Podiatr Med Surg. 2016; 33: 139-152
- Plantar release in the correction of deformities of the foot in childhood.J Bone Joint Surg Am. 1981; 63: 1382-1389
- Endoscopic plantar fascia release: a cross-sectional anatomic study.Foot Ankle Int. 1997; 18: 398-401
- Pes cavovarus: review of a surgical approach using selective soft-tissue procedures.J Bone Joint Surg Am. 1980; 62: 942-953
- Plantar opening-wedge osteotomy of cuneiform bones combined with selective plantar release and Dwyer osteotomy for pes cavovarus in children.J Pediatr Orthop. 2006; 26: 100-108
- Anatomic study of the medial neurovascular structures in relation to calcaneal osteotomy.Foot Ankle Int. 2001; 22: 569-571
- Tibial nerve palsy associated with lateralizing calcaneal osteotomy: case reviews and technical tip.Foot Ankle Int. 2009; 30: 258-261
- Neurologic deficit associated with lateralizing calcaneal osteotomy for cavovarus foot correction.Foot Ankle Int. 2016; 37: 1106-1112
- The effect of medial and lateral calcaneal osteotomies on the tarsal tunnel.Foot Ankle Int. 2014; 35: 383-388
Published online: April 04, 2018
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.