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What Is a Calcaneal Osteotomy?

Calcaneal osteotomy is surgery in which the heel bone, or calcaneus, is cut and repositioned to correct foot alignment. It is a joint-preserving procedure because the surgeon changes the position or shape of the bone without intentionally fusing the nearby joints. The heel can be shifted medially or laterally, lengthened, or modified using another osteotomy pattern. The selected technique depends on the type and severity of deformity.

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What Is a Calcaneal Osteotomy?

Calcaneal osteotomy is surgery in which the heel bone, or calcaneus, is cut and repositioned to correct foot alignment. It is a joint-preserving procedure because the surgeon changes the position or shape of the bone without intentionally fusing the nearby joints. The heel can be shifted medially or laterally, lengthened, or modified using another osteotomy pattern. The selected technique depends on the type and severity of deformity.

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Why Is Calcaneal Osteotomy Performed?

Calcaneal osteotomy is used to correct hindfoot valgus, hindfoot varus, flexible flatfoot, cavovarus deformity, and selected other alignment problems. Repositioning the heel changes how body weight and tendon forces pass through the foot. The procedure is commonly combined with tendon repair, ligament reconstruction, Achilles or calf lengthening, or other bone procedures. Surgery is considered when symptoms and deformity remain significant despite appropriate nonsurgical treatment.

How Is Calcaneal Osteotomy Performed?

The surgeon makes an incision near the heel and uses a saw or osteotome to create a controlled cut through the calcaneus. The bone segment is shifted, rotated, or lengthened to achieve the planned alignment. Screws, plates, staples, or other fixation devices hold the bone while it heals. Fluoroscopy or other imaging can be used during surgery to confirm position and hardware placement.

What Is Recovery Like After Calcaneal Osteotomy?

The foot is protected in a splint, cast, or boot while the bone begins to heal. Patients commonly avoid or limit weight-bearing for several weeks, although the exact schedule depends on the osteotomy, fixation, and additional procedures. Follow-up X-rays are used to assess bone healing before full weight-bearing and higher-impact activity progress. Physical therapy can help restore ankle motion, strength, gait, and balance after the surgeon permits increased activity.

What Are the Risks and Complications?

Possible complications include infection, wound problems, blood clots, delayed union, nonunion, malunion, persistent pain, or hardware irritation. The sural nerve and other nearby nerves can be stretched or injured, causing numbness or painful sensitivity. Overcorrection or undercorrection can leave residual alignment problems. Some patients later need hardware removal or additional reconstructive surgery.

Frequently Asked Questions About Calcaneal Osteotomy

Is calcaneal osteotomy a heel fusion?

No. An osteotomy cuts and repositions the heel bone while preserving the surrounding joints. Fusion intentionally joins two or more bones across a joint.

How long is weight-bearing restricted after calcaneal osteotomy?

Restriction commonly lasts several weeks until early bone healing is visible. The exact timeline depends on the osteotomy, fixation, other procedures, and surgeon's protocol.

Are screws always used after calcaneal osteotomy?

Internal fixation is usually needed, but the device can be screws, a plate, staples, or another system. The choice depends on the osteotomy pattern and surgeon preference.

Can calcaneal osteotomy correct flatfoot?

Yes. A medial displacement or lengthening calcaneal osteotomy can be part of reconstruction for selected flexible flatfoot deformities.

References

Progressive Collapsing Foot Deformity (Flatfoot). OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/posterior-tibial-tendon-dysfunction/. Date Accessed August 12, 2026.

Calcaneus osteotomy. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC4596212/. Date Accessed August 12, 2026.

Complications of Calcaneal Osteotomy: Are They Equal Between Different Osteotomy Types? PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8793527/. Date Accessed August 12, 2026.

Types of Sliding Calcaneal Osteotomy Fixation: A Systematic Review and Meta-Analysis. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC9858884/. Date Accessed August 12, 2026.

Minimally invasive surgery in medial displacement calcaneal osteotomy for acquired flatfoot deformity: a systematic review of the literature. PubMed. https://pubmed.ncbi.nlm.nih.gov/38212588/. Date Accessed August 12, 2026.