Posterior calcaneal osteotomy. Effect, technique, and indications.

Posterior calcaneal osteotomy is a technically simple procedure that may be used to correct frontal, transverse, or sagittal plane displacement of the calcaneus associated with flatfoot deformity. In selected individuals, subluxation about the oblique axis of the midtarsal joint may be stabilized. Forefoot supinatus may be expected to reduce secondary to the reduction of heel valgus obtained, although with deformity chronicity, adaptive midtarsal joint changes may necessitate medial column stabilization. Posterior calcaneal osteotomy increases rotational stability of the subtalar joint in a supinatory direction. In addition, displacement of the posterior calcaneal fragment effects a dynamic correction force by translocation of the Achilles tendon and its posterior relation to the axis of the subtalar joint.