Northumbria NHS Foundation Trust, Wansbeck General Hospital Department of Trauma & Orthopaedics, Woodhorn Lane, Northumberland NE63 9JJ, UK.
Gateshead Health NHS Foundation Trust, Queen Elizabeth Hospital, Gateshead, Tyne and Wear NE9 6SX, UK.
Foot Ankle Surg. 2024 Feb;30(2):161-164. doi: 10.1016/j.fas.2023.11.001. Epub 2023 Nov 4.
Calcaneal osteotomies correct hindfoot deformities and are often performed using a minimally invasive technique. The aim was to compare the safety of three calcaneal osteotomy techniques (oblique, chevron with apex anterior and chevron with apex posterior).
Each osteotomy technique was performed on five cadavers (n = 15). These were then dissected to identify any injury to the neurovascular bundles. The distance between the burr and these structures was measured.
Using the apex posterior technique, the burr was closer to the medial and lateral neurovascular structures, and in one case the sural nerve was injured. There were no neurovascular injuries using the other techniques.
Minimally invasive surgery using a burr is generally a safe, reliable method for performing calcaneal osteotomies. The chevron with apex posterior osteotomy should be performed with caution given the closer relationship between the burr and neurovascular bundles. The other two techniques provide safer alternatives.
跟骨截骨术可矫正后足畸形，通常采用微创技术进行。目的是比较三种跟骨截骨术（斜形、前顶楔形和后顶楔形）的安全性。
对 5 具尸体（n=15）分别采用 3 种截骨术式进行操作。然后对这些标本进行解剖，以确定是否有神经血管束损伤。测量磨钻与这些结构之间的距离。
采用后顶楔形截骨术时，磨钻更靠近内侧和外侧的神经血管结构，有 1 例损伤了腓肠神经。另外两种技术则没有神经血管损伤。
使用磨钻的微创技术通常是一种安全、可靠的跟骨截骨方法。由于跟骨后顶楔形截骨术与神经血管束的关系更密切，因此应谨慎操作。另外两种技术提供了更安全的选择。
