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. 2021 Jan;103(1):77-79.
doi: 10.1308/rcsann.2020.0207. Epub 2020 Oct 16.

The King's Cut: the sliding hindfoot osteotomy for talar body collapse

A R Rabiu  1 , S Lyle  1 , I Reichert  1 , R Ahluwalia  1
Affiliations

The King's Cut: the sliding hindfoot osteotomy for talar body collapse

A R Rabiu et al. Ann R Coll Surg Engl. 2021 Jan.
No abstract available

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Figures

Figure 1
Figure 1
Schematic diagram of AVN of the talus and the anterior subluxation of the talus on the tibia. The necrotic talar body that is cut at a sloped angle osteotomy in the sagittal plane creates a wedge-shaped talus and does not extend into the talar neck or head to preserve blood flow. The middle figure shows the traditional cuts and consequent shortening. The use of the sliding osteotomy allows the tibial medullary canal to be centred over the foot for nail insertion and reduces limb shortening as demonstrated by the inferior guidelines.
Figure 2
Figure 2
Using a pre-drilled hole, we demonstrate talus body removal, with the corresponding oblique osteotomy made in the distal tibia, which allows the talus or foot to slide on over each other with bony apposition between the two surfaces. Once the osteotomy has been completed, the position is confirmed and the application of nail confirms the position of osteotomy and fixation with a plantigrade foot, the nail is positioned according to the technical guide.
Figure 3
Figure 3
An example of the use of the sliding osteotomy in a diabetic Charcot reconstruction, which is accompanied by long-segment fixation. Postoperative images show the cuts and stabilisation of the talus head and neck on the tibia with a solid union.
See this image and copyright information in PMC

References

    1. Royer C, Brodsky J. Arthrodesis Techniques for Avascular Necrosis of the Talus. Foot Ankle Surg 2002; : 50–59.
    1. Kou J, Weinfeld S. Tibiotalocalcaneal Nailing: Indications and Technique. Foot Ankle Surg 2009; : 126–133. - PubMed

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