MDCO or LDCO (Medializing/Lateralizing Displacement Calcaneal Osteotomy) is a common procedure that is often used as an adjunct for hindfoot realignment in deformity correction surgery. It is an extra-articular joint sparing procedure. The amount of proportional displacement needed depends on severity of the deformity. Various kinds of screws and/or plates are currently used with demonstrable limitations, complications and in some cases, a need for additional surgery to remove implants. An innovative subcortical implant is discussed to prevent these issues.

INDICATIONS:
Varus or valgus malalignment of calcaneus and increased calcaneal pitch due to Chronic Progressive Foot Deformity (CPFD), previously known as Adult Acquired Flatfoot deformity, Talipus Equino Cavovarus, Residual club foot deformity.

ISSUES WITH SCREWS:
Imprecise displacement, limited real estate for placement of screw, need for intraoperative calcaneal view xrays increases intraoperative time and radiation exposure, additional posterior heel incision can be painful due to scar tissue, painful hardware due to prominent screw heads. Illustrations are provided.

ISSUES WITH PLATES:
Fixed displacement amount depending on availability of limited sizes of plates, painful hardware due to step plate and/or prominent screws. Illustrations are provided.

INNOVATIVE BRACKET DESIGN:
Precise displacement can be achieved from 6 mm to 15+ mm. L bracket with three screws is placed entirely subcortical without any prominence of screws. Excellent compression at osteotomy site is achieved due to differential threads. No additional incision is needed on posterior heel as the bracket is applied through the osteotomy incision. Illustrations are provided.

ILLUSTRATIVE TECHNIQUE SLIDES:
This technique is demonstrated to present easy, reproducible, and precise displacement of the medializing/lateralizing calcaneal osteotomy with excellent compression.

CLINICAL CASE EXAMPLES:
Preoperative, intraoperative and postoperative clinical and radiographic images are presented.

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Precision Calcaneal Slide Osteotomy

Precision Calcaneal Slide Osteotomy

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Precision Calcaneal Slide Osteotomy

Precision Calcaneal Slide Osteotomy

Introduction

More ISAKOS 2021: Global Content