Effect of Lateral Sliding Calcaneus Osteotomy on Tarsal Tunnel Pressure

Halm, Sebastian; Fairhurst, Paul G.; Tschanz, Stefan; Wieland, Fluri A. M.; Djonov, Valentin; Krause, Fabian (2020). Effect of Lateral Sliding Calcaneus Osteotomy on Tarsal Tunnel Pressure. Foot & Ankle Orthopaedics, 5(3), p. 247301142093101. 10.1177/2473011420931015

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Background:

Lateral sliding calcaneus osteotomies are common procedures to correct hindfoot varus deformities. Shifting the calcaneal tuberosity laterally (lateralization) can lead to tarsal tunnel pressure increase and tibial nerve palsy. The purpose of this cadaveric biomechanical study was to investigate the correlation of lateralization and pressure increase underneath the flexor retinaculum.

Methods:

The pressure in the tarsal tunnel of 12 Thiel-fixated human cadaveric lower legs was measured in different foot positions and varying degrees of calcaneal lateralization.

Results:

The mean pressure increased from plantarflexion (PF) to neutral position (NP) and from NP to hindfoot dorsiflexion (DF), and with increasing amounts of lateralization of the calcaneal tuberosity. The mean baseline pressure in PF was 1.5, in NP 2.2, and in DF 6.5 mmHg and increased to 8.1 in PF, 18.4 in NP, and 33.1 mmHg with 12 mm of lateralization. The release of the flexor retinaculum significantly lowered the pressure.

Conclusion:

Increasing pressures were found in the tarsal tunnel with increasing lateralization of the tuberosity and with both dorsiflexion and plantarflexion of the ankle.

Clinical Relevance:

A pre-emptive release of the flexor retinaculum for a lateralization of the calcaneal tuberosity of more than 8 mm should be considered, especially if specific patient risk factors are present. No tibial nerve palsy should be expected with 4 mm of lateralization.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy > Topographical and Clinical Anatomy
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Halm, Sebastian; Fairhurst, Paul Gilbert Arthur Penn; Tschanz, Stefan A.; Wieland, Fluri Anton Martin; Djonov, Valentin Georgiev and Krause, Fabian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2473-0114

Language:

English

Submitter:

Sebastian Halm

Date Deposited:

06 Jan 2021 10:03

Last Modified:

10 Jan 2021 02:51

Publisher DOI:

10.1177/2473011420931015

BORIS DOI:

10.48350/149687

URI:

https://boris.unibe.ch/id/eprint/149687

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