The Case for Joint-Preserving Surgery

Core decompressionCore decompression is indicated when the disease occasionally presents at Maceira stage I with no bony abnormality detectable on plain radiographs. Based on the notion of mandatory heel varusHeel varus, some centers advocate lateral displacement calcaneal osteotomyCalcaneal osteotomy only in Müller-Weiss diseaseMüller-Weiss disease, preserving all the diseased midfoot joints. Should this joint-preserving surgery fail, arthrodesis can always be performed later with the added advantage of heel varusHeel varus having already been corrected by calcaneal osteotomyCalcaneal osteotomy. On a cautionary note, the presence of heel varus should be verified preoperatively by obtaining a hindfoot alignment radiograph. Contrary to the previous approach, Egyptian adolescents underwent calcaneal lengthening instead to simultaneously correct flatfoot and midfoot abductionMidfoot abduction. Geographical differences may exist that deserve further investigation.