Insertional Achilles tendinosis: The Zadek Osteotomy - preop planning and step by step resection

In this video we discuss an osteotomy used to off load the insertion of the achilles tendon - the Zadek osteotomy. According to the original article, the Zadek osteotomy is a surgical procedure used to treat Haglund's syndrome, a condition characterized by a bony prominence at the back of the heel that causes pain and discomfort [[3](https://www.sciencedirect.com/science...)]. The osteotomy involves cutting and reshaping the calcaneus bone in the heel using a cuneiform closing wedge technique with a dorsal and posterior base [[3](https://www.sciencedirect.com/science...)]. The goal is to reorient the calcaneus and decrease the posterior prominence, thereby decreasing stress to the achilles tendon. It also changes the achilles tendon lever arm and effectively results in an indirect achilles tendon lengthening effect. Both open and minimally invasive techniques have been used to perform the Zadek osteotomy [[3](https://www.sciencedirect.com/science...)]. In this video we discuss a case where calcaneal osteotomy was used combined with an MIS approach. Technique Article link: Nordio A, Chan JJ, Guzman JZ, Hasija R, Vulcano E. Percutaneous Zadek osteotomy for the treatment of insertional Achilles tendinopathy. Foot Ankle Surg. 2020 Oct;26(7):818-821. doi: 10.1016/j.fas.2019.10.011. Epub 2019 Nov 20. PMID: 31784097. https://pubmed.ncbi.nlm.nih.gov/31784... Instrumentation Used in photos: Arthrex MIS burr: (https://www.arthrex.com/foot-ankle/pe...) -Standard calc osteotomy burr is a 20x3.1 mm burr to create the limbs -conical burr 13x4.3 is used to help remove the bone - Arthrex CompFT compression screws: (https://www.arthrex.com/it/risorses/p...)