Osteotomy (Bone Cutting & Realignment) in Foot & Ankle Surgery

WHAT IS AN OSTEOTOMY?

An osteotomy is a surgical procedure where a bone is carefully cut and repositioned to improve alignment, relieve pressure, or correct deformity. In the foot and ankle, osteotomies are commonly used to treat bunions, flatfoot, high arches, malunions, and other structural problems that affect how the foot functions.

Why Do Surgeons Perform Osteotomies?

When a bone is out of alignment, simply working on the soft tissues is often not enough. An osteotomy allows the surgeon to change the actual shape or position of the bone so that the foot can function more normally.

Correcting Deformity: Such as bunions, flatfoot (pes planus), high arches (cavus foot), or malunited fractures.

Shifting Pressure: Moving the bone so weight is distributed more evenly across the foot, reducing pain in overloaded areas.

Improving Joint Mechanics: Realigning the bone can help joints track more naturally and reduce abnormal wear.

Preparing for Other Procedures: Osteotomies are often combined with tendon transfers, fusions, or ligament reconstructions.

Common Osteotomies in Foot & Ankle Surgery:

Many osteotomies in the foot and ankle are named after the surgeons who first described them. Also many times they are just named after the bone being cut -or to make things more confusion sometimes they have both names. The specific type used depends on which part of the foot or ankle needs correction.

Calcaneal Osteotomy: Cutting and shifting the heel bone to correct flatfoot or cavus deformity.

Evans Osteotomy: A lengthening cut in the outer side of the calcaneus (heel bone) used for certain types of flatfoot correction.

Metatarsal Osteotomy: Bone cuts in the forefoot, often used in bunion surgery or to treat metatarsalgia.

First Ray Osteotomy: To realign the first metatarsal in bunion correction procedures.

Midfoot / Forefoot Osteotomies: To correct complex deformities after trauma or long-standing arthritis.

In many cases, more than one osteotomy may be performed in the same surgery to fully correct the shape of the foot.

How Is the Bone Held in Its New Position?

After the bone is cut and repositioned, it needs to be held securely so it can heal in the new alignment. Specialized implants are used to stabilize the osteotomy until the bone has fully healed.

Screws: Often buried inside the bone and designed to stay in permanently.

Plates: Low-profile metal plates used to support more complex cuts or weightbearing areas.

Pins or Wires: Sometimes used temporarily in smaller bones or less complex corrections.

External Fixation: In selected cases, an external frame may be used to gradually adjust the position of the bone over time.

Osteotomy Foot & Ankle Surgery FAQs Frequently asked questions

What is an osteotomy in foot surgery?

In foot and ankle surgery, an osteotomy is a controlled cut in the bone that allows the surgeon to change the bone’s position or angle. This can correct deformities, shift pressure, and improve how the foot functions.

How long does it take for an osteotomy to heal?

Bone healing typically takes 6 to 12 weeks, depending on the location and size of the osteotomy and your overall health. During this time, you may be in a cast or boot and your weightbearing will be carefully controlled.

Will I have metal in my foot permanently after an osteotomy?

Most screws and plates used to fix osteotomies are designed to stay in permanently and do not cause problems. They are only removed if they become prominent or irritating, which is uncommon.

Is an osteotomy always done alone, or is it combined with other procedures?

Osteotomies are frequently combined with other procedures such as tendon transfers, ligament repairs, or joint fusions to fully correct a deformity or instability. The exact combination is tailored to your specific condition.

Advanced Bone Realignment & Reconstruction

Dr. David Gitlin is a board-certified foot and ankle surgeon with 25 years of experience in complex osteotomies for flatfoot, bunions, high-arch deformities, and post-traumatic problems. He treats patients in Naples, Florida, Miami, Fort Lauderdale, and New York City, focusing on precise bone realignment to restore a more natural, pain-free gait.