Single-Incision Peroneal Tendon Repair With Concomitant Modified Dwyer Calcaneal Osteotomy: Report of 15 Cases With Plate Fixation.

Abstract

Addressing hindfoot varus via calcaneal osteotomy with simultaneous peroneal tendon repair from a single incision has not been thoroughly assessed. Some concerns with one incision are wound complications, nerve damage, and symptomatic hardware. Patients operated on by one surgeon May 2012 to January 2022 were retrospectively reviewed with minimum 2-year follow-up via in-person visit, telephone, and chart review. Patients with peroneal tendon repair in conjunction with a modified Dwyer (with lateral shift) osteotomy fixated with a laterally applied locking plate were included. Those whose osteotomies were fixated with posteriorly applied screws were excluded. Fifteen patients were assessed, 13 males and 2 females, average age 56.9 ± 9.9 years. There were no wound complications or nerve injuries. One patient elected to have plate removal. There was 1 deep vein thrombosis. Return to activity including sports was 5.3 ± 1.3 months. On average, postoperative Roles and Maudsley and AOFAS hindfoot scores improved to "significant from pre-treatment" 11 with "excellent" results. Peroneal tendon repair can be performed through the same incision as a modified Dwyer calcaneal osteotomy to address hindfoot varus deformity. In this series, there were no wound or nerve issues.