Title
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Relationship of the Scarf valgus-inducing osteotomy of the calcaneus to the medial neurovascular structures
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Author
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Abstract
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The Scarf valgus inducing osteotomy of the calcaneus is an operative technique to correct varus deformity of the hindfoot. It is versatile with significant corrective power; however, the neurovascular structures are in close proximity on the medial side and thus may be harmed during the osteotomy. Moreover, because this type of osteotomy can cause a great lateral translation, traction of the medial neurovascular structures is possible. We performed an anatomic study to evaluate the medial soft tissues after a lateralizing Scarf-type calcaneal osteotomy. Materials and Methods: The osteotomies were carried out on ten fresh-frozen cadaver specimens. We performed the osteotomy and induced valgus. Then we performed a medial dissection to identify the important medial structures: the medial and lateral plantar nerve (MPN , LPN) and the posterior tibial artery (PTA). We noted their relation to the osteotomy and their integrity. Results: In several cases, one or more of the structures were sectioned. In five cases, all the structures crossed the osteotomy, four of which even a transection of one or both of the plantar nerves occurred. Although the PTA crossed the osteotomy in eight specimens, there was no transection of this structure. Conclusion: Scarf osteotomy of the calcaneus is a highly corrective osteotomy. However, caution must be exercised when performing as the medial neurovascular structures cross the osteotomy lines and transection can occur. Clinical Relevance: When performing the osteotomy one should keep in mind that vigorous sawing and large displacement can cause damage to the medial neurovascular structures. |
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Language
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English
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Source (journal)
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Foot and ankle international. - Baltimore, Md
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Publication
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Baltimore, Md
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2011
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ISSN
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1071-1007
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DOI
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10.3113/FAI.2011.0540
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Volume/pages
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32
:5
(2011)
, p. 540-544
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ISI
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000290139700012
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Full text (Publisher's DOI)
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