Scientific Articles   |    
Distraction Osteogenesis for Complex Foot Deformities: Surgical Technique for U-Osteotomy with External Fixation
Bradley M. Lamm, DPM, FACFAS1; Monique C. Gourdine-Shaw, DPM2; John E. Herzenberg, MD, FRCSC1
1 International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215. E-mail address for B.M. Lamm: blamm@lifebridgehealth.org. E-mail address for J.E. Herzenberg: jherzenberg@lifebridgehealth.org
2 Department of Podiatry, Medical Service Corps, United States Navy, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600. E-mail address: monique.gourdineshaw@med.navy.mil
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Based on an original article: J Bone Joint Surg Am. 2012 Aug 1;94(15):1420-7.

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2012 Sep 26;2(3):e18 1-12. doi: 10.2106/JBJS.ST.L.00012
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



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

Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Essential Surgical Techniques?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    Provided by:
    Essential Surgical Techniques
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Results provided by:
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    New York - Icahn School of Medicine at Mount Sinai
    Connecticut - Yale University School of Medicine