The U-osteotomy of the talus and calcaneus with external fixation provides gradual osseous correction of the entire foot relative to the tibia to create a plantigrade foot position while leaving the ankle joint undisturbed.
Step 1: Plan Deformity Correction
Conduct a thorough history, physical examination, and radiographic analysis.
Step 2: Perform U-Osteotomy
Make a modified Ollier-type incision and perform a multiple-drill-hole osteotome osteotomy through the talus and calcaneus.
Step 3: Apply External Fixation
Apply a Taylor Spatial Frame for gradual simultaneous multiplanar correction driven by a computer-based software program.
Step 4: Gradually Correct Deformity
After applying the external fixation, gradually correct the deformity.
Step 5: Remove External Fixation
After confirming radiographic consolidation, remove the external fixation in the operating room.
Osseous union and a plantigrade foot were achieved in all fifteen patients in our series despite seven complications related to the U-osteotomy.
What to Watch For
Pitfalls & Challenges