A calcaneal osteotomy is an operation to cut and reposition the heel bone to correct hindfoot alignment. It is used to treat valgus (flat) or varus (high-arched) heel deformities.
An incision is made on the outer side of the heel. The calcaneus (heel bone) is cut and shifted — medially (inward) for valgus correction or laterally (outward) for varus correction. The bone is fixed in its new position with screws. For varus correction, a wedge of bone may be removed (closing wedge — Dwyer). The operation takes 45-90 minutes.
Calcaneal osteotomy is commonly performed as part of flatfoot reconstruction (medial displacement osteotomy), cavovarus foot correction, or to improve hindfoot alignment in ankle arthritis or instability.
Orthotics, supportive footwear, physiotherapy, and bracing. These manage symptoms but cannot correct a structural deformity.
Weight-bearing X-rays. Often combined with other procedures.
Correction of heel alignment improves foot mechanics, reduces pain, and protects adjacent joints. Union rates exceed 95%.
Discomfort at the osteotomy site for several months.
Heel swelling.
Numbness on the outer heel.
Failure to heal. Uncommon in the calcaneus.
Excessive shift.
Lateral heel skin is vulnerable.
Tendons may be irritated by the shifted bone.
General or spinal anaesthesia with ankle block.
Non-weight-bearing for six weeks, then progressive weight-bearing in a boot. Physiotherapy. Full recovery three to six months.
X-rays at six weeks and three months.
Calcaneal osteotomy is most commonly performed in combination with other procedures such as tendon transfer or spring ligament repair for flatfoot correction.