Dorsal wedge calcaneal osteotomy as surgical treatment for insertional Achilles tendinopathy

• Published in: Revista española de cirugía ortopédica y traumatología 2020-01, Vol.64 (1), p.22-27
• Main Authors: López-Capdevila, L., Santamaria Fumas, A., Dominguez Sevilla, A., Rios Ruh, J.M., Pich Aguilera, E., Boo Gustems, N., Roman Verdasco, J., Gordillo Uribe, J., Sales Perez, M.
• Format: Article
• Language: English
• Subjects: Calcaneal osteotomy; Insertional Achilles tendinopathy; Osteotomía calcánea; Tendinopatía insercional de Aquiles; Zadek
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2019.11.003

The dorsal wedge calcaneal osteotomy aims to reduce the length of the calcaneus and elevate the insertion of the Achilles tendon, leading to a reduction of Achilles tension in its insertion. The purpose of this study is to assess the clinical and functional results of this osteotomy in patients with insertional Achilles tendinopathy and a high calcaneal inclination angle. This is a retrospective study with 18 patients diagnosed with insertional Achilles tendinopathy, who were treated by dorsal wedge calcaneal osteotomy, excision of the wedge and fixation with 2 cannulated screws. The VAS, AOFAS ankle-hindfoot, VISA-A and patient satisfaction scales were performed preoperatively and postoperatively. The radiological parameters analysed were the calcaneal inclination angle, the calcaneal length and the Fowler–Philips angle. A statistical analysis was performed. The mean follow-up was 18.3 months (range 14–36). All patients reported relief from symptoms. The VAS scale improved from 8.25 to 2.16 points; and the AOFAS score rose from 41.5 to 86.5 points (p