Calcaneal Osteotomy Causes Misalignment of the Calcaneus Bone and Severe Chronic Pain

Case Overview

This case involves a 46-year-old female who suffered from synovitis of the foot and subsequently underwent surgical treatment due to several failed attempts to treat the condition with conservative medical management. The surgery was uneventful and proceeded without complication but the patient experienced some post-operative pain and swelling. At the point in which the patient tried to ambulate she experienced significant hind foot pain and her gait was altered compared to her state before the surgery. The surgeon noted in his reports that the patient displayed signs of a varus mal-alignment and that she may need an additional surgery to slide her heel back and close the wedge that had developed.

Questions to the Orthopedic Surgery expert and their responses

Is it possible that the surgeon performed an unnecessary calcaneal osteotomy which resulted in misalignment of the calcaneus bone and severe chronic pain?

A calcaneal osteotomy is not commonly required. The risks of a calcaneal osteotomy include infection, nonunion, over correction and under correction, neurovascular injury, metal breakage if metal is used. As far as this particular case, the primary justification for calcaneal osteotomy would be malalignment such as hindfoot valgus (basically a severe flat foot) or less commonly hindfoot varus which is where the back part of the foot is turned in toward the other foot. Sometimes if there is an angular deformity after fracture it can require osteotomy to correct.

About the expert

This expert earned his BS in optical engineering from the University of Rochester and his MD at the State University of New York at Buffalo. He completed a residency in orthopedic surgery at Case Western University and his fellowship in foot and ankle surgery at Cornell University. He is a member of the American Academy of Orthopedic Surgeons and the American Orthopedic Foot and Ankle Surgeons. He formerly served as the co-director of primary care orthopedics at Harvard University and the director of foot and ankle orthopedics at Massachusetts General Hospital. He is currently a reviewer for the Journal of the American Academy of Orthopedic Surgeons and an orthopedic surgeon for a physician group in Florida.

E-001282

Specialties:

Orthopedic Surgery

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