Surgical Procedure
Curved lateral incision
Create surface area for osteotomy. Be aware of sural nerve and peroneal tendons.
Create room for Hohman retractors by using curved pereosteal elevator.
Place Hohman retractors
Place positioning device with an angle of 45 degrees.
Dismount removable part
Pearls & Pitfalls
Pearls
Pay extra attention to angle of the osteotomy. This should be performed in an angle of 33° to 45° relative to the plantar surface of the foot.
It is important to know if one is lateralizing or medializing the posterior fragment. In case of lateralizing the pins of the sawing jig should be facing towards the anterior part of the calcaneus. When medializing the fragment, the pins of the sawing jig should be facing towards the posterior fragment of the calcaneus.
Pitfalls
It is important to dissect the subcutaneous tissue sufficient of the calcaneus, so that the sawing jig will not be placed to distal to the posterior side of the calcaneus.
Make sure to saw unto the overlying cortex of the calcaneus and to tap this before sawing.