Stage II flatfoot: what fails and why

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Stage II flatfoot: what fails and why Keith Hill, MD, William E Saar, DO, Thomas H Lee, MD, Gregory C Berlet, MD  Foot and Ankle Clinics  Volume 8, Issue 1, Pages 91-104 (March 2003) DOI: 10.1016/S1083-7515(03)00008-1

Fig. 1 Intraoperative view of medial displacement calcaneal osteotomy. Note lateral start position of the guidewire relative to the tuberosity. Placing the guidewire laterally allows for proper position after medial shift is accomplished and injury to medial neurovascular structures is avoided. Fixation should be placed perpendicular to the osteotomy. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)

Fig. 2 The Bob osteotomy, which places the cut perpendicular to the posterior facet, allows the osteotomy to translate proximally, and violates the subtalar joint. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)

Fig. 3 Nonunion of calcaneal osteotomy despite proper placement and fixation. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)

Fig. 4 Calcaneal specimen demonstrating the confluence of anterior and middle facets found in two thirds of the population. AF, anterior facet; MF, middle facet; PF, posterior facet;. The arrow denotes the confluence of AF and MF. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)

Fig. 5 (A)Preoperative and (B) postoperative lateral radiographs of Evans lateral column lengthening and combined medial displacement osteotomy. Tricortical graft in the anterior process is secured with an H-plate. Note that the longitudinal arch is re-established. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)

Fig. 5 (A)Preoperative and (B) postoperative lateral radiographs of Evans lateral column lengthening and combined medial displacement osteotomy. Tricortical graft in the anterior process is secured with an H-plate. Note that the longitudinal arch is re-established. Foot and Ankle Clinics 2003 8, 91-104DOI: (10.1016/S1083-7515(03)00008-1)