Minimally Invasive Medialising Calcaneal Osteotomy (MIMCO)

Abstract Background Medialising calcaneal osteotomy is a common procedure usually done in tandem with other procedures like lateral column lengthening or subtalar arthroereisis, flexor digitorum longus transfer, with or without heel cord lengthening, spring ligament repair and tibialis posterior tendon debridement for the treatment of symptomatic adult – acquired flatfoot deformities (AAFD). The procedure has historically been done via open approaches which are associated with the risk of wound complications and nerve injury. Recently there has been a shift towards more minimally invasive techniques. Methods Minimally invasive medialising calcaneal osteotomy (MIMCO) is performed percutaneously under fluoroscopy using a high torque, low speed, and saline cooled burr and can be secured with a single cannulated screw, with minimal soft tissue dissection. Results and Conclusions MIMCO provides surgeons with a safe and reliable tool to correct hindfoot deformities that is comparable to the open procedure but with added potential advantages of decreased postoperative pain, wound complications and iatrogenic injury to neurovascular structures.