Calcaneal Osteotomy (lateralizing) 28300

 
CPT Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:

 Lateralizing Calcaneal Osteotomy CPT

  •  28300 Osteotomy, calcaneous (e.g. Dwyer, or Chambers type procedure) with or without internal fixation

Lateralizing Calcaneal Osteotomy Indications

  • Residual hindfoot varus

 Lateralizing Calcaneal Osteotomy Contraindications

  •  Anterior ankle impingement

Lateralizing Calcaneal Osteotomy Alternatives

  • A

Lateralizing Calcaneal Osteotomy Pre-op Planning

  • Consider concomittant dorsiflexion osteotomy of the first ray or dorsiflexion fusion of the first TMT joint if the first ray is plantarflexed (common in CMT disease)
  • Consider excising posterior or medial subtalar joint osteophytes commonly seen in patients with cavovarus foot.

Lateralizing Calcaneal Osteotomy Technique

  • Posterior lateral incision.
  • Dissection to the calcaneus.
  • Transverse calcaneal osteotomy.  Ensure medial aspect of cut is not near the sustentaculum tali (NV bundle).
  • Mobilize the tuberostiy fragment and Achilles.
  • Translate tuberosity fragment laterally.
  • Place two cannulated screws using standard AO technique perpendicular to the plane of the osteomy.
  • Trim lateral aspect of tuberosity fragment and use as bone graft.
  • C-arm views (lateral ankle and Broden views) taken to ensure screws do not penetrate the subtalar joint.
  •  

Lateralizing Calcaneal Osteotomy Complications

Lateralizing Calcaneal Osteotomy Follow-up care

  • Post-op:Bulky posterior splint, NWB
  • 7-10 Days: Wound check, Place in walker boot, or short leg cast;  NWB.  Begin gentle ankle ROM exercises if any concomittant peroneal tendon procedures have been performed
  • 6-8 Weeks: WBAT in walker boot provided union is evident on xray. Begin physical therapy.
  • 3 Months: begin sport specific physical therapy /  training
  • 4-6 Months: return to full competition/sport with ankles taped or in athletic ankle brace.
  • 1Yr:Follow up eval, Ankle/Foot outcomes testing.  

Lateralizing Calcaneal Osteotomy Outcomes

  • (R

Lateralizing Calcaneal Osteotomy Review References

  • Younger AS, JAAOS 2005;13;302

 

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate. While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer.