Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Calcaneal osteotomy — surgical cutting and repositioning of the heel bone — is a powerful corrective procedure for correcting hindfoot alignment deformities that drive progressive foot and ankle pathology. The procedure is central to the surgical management of adult-acquired flatfoot, cavovarus foot, and Achilles tendinopathy with hindfoot valgus, providing lasting realignment that orthotic therapy alone cannot achieve.

Biomechanical Rationale

The calcaneus is the keystone of hindfoot alignment. Excessive valgus tilting of the calcaneus (pronated foot) loads the medial column, stresses the plantar fascia and posterior tibial tendon, and increases medial ankle compartment forces. Excessive varus (supinated foot) overloads the lateral column and peroneal tendons, increasing lateral ankle instability risk. Calcaneal osteotomy corrects the underlying skeletal alignment rather than managing only the soft tissue consequences of malalignment.

Medializing Calcaneal Osteotomy (Evans / Lateral Column Lengthening)

The medializing (or lateral displacement) calcaneal osteotomy — performed via an oblique cut through the calcaneal tuberosity — shifts the heel medially 8–12mm to correct hindfoot valgus in adult-acquired flatfoot. This shifts the Achilles tendon vector medially, restoring its function as a hindfoot inverter and reducing stress on the posterior tibial tendon. The Evans osteotomy (anterior calcaneal lengthening) addresses forefoot abduction in flatfoot by inserting a bone graft to lengthen the lateral column. Both are commonly combined with medial soft tissue reconstruction (FDL transfer, spring ligament repair) in Stage II PTTD flatfoot surgery.

Dwyer Osteotomy (Lateralizing / Closing Wedge)

The Dwyer osteotomy removes a laterally-based closing wedge from the calcaneal tuberosity to correct hindfoot varus deformity in cavovarus foot. This shifts the Achilles tendon vector laterally, reducing peroneal tendon stress and improving lateral column loading. The Dwyer procedure is typically combined with plantar fascia release and peroneus longus-to-brevis transfer in cavovarus reconstruction surgery.

Surgical Technique and Recovery

Calcaneal osteotomies are performed under regional or general anesthesia, secured with cannulated screws or staples to maintain correction during healing. Non-weight-bearing for 6–8 weeks is required while the osteotomy heals, followed by progressive weight bearing in a walking boot over the next 4–6 weeks. Most patients achieve stable bone healing and functional ambulation by 4–5 months postoperatively, with return to athletic activity at 6–9 months. Hardware removal is occasionally required for symptomatic implants.

Calcaneal Realignment at Balance Foot & Ankle

Dr. Biernacki at Balance Foot & Ankle evaluates hindfoot alignment with weight-bearing radiographs and clinical biomechanical assessment at your first visit. Patients requiring calcaneal osteotomy are comprehensively evaluated and surgical planning coordinated with complete preoperative imaging. Call (810) 206-1402 for a same-week evaluation of hindfoot pain or deformity.

When to See a Podiatrist

Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:

• Pain that persists for more than 2 weeks despite rest
• Swelling, redness, or warmth that isn’t improving
• Numbness, tingling, or burning in the feet
• A wound or sore that is not healing within 2 weeks
• Any foot concern if you have diabetes or poor circulation
• Nail changes that suggest fungal infection or other problems

At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.

Calcaneal Osteotomy Surgery in Michigan

Calcaneal osteotomies realign the heel bone to correct flatfoot, cavus foot, and heel varus/valgus deformities. Our surgeons perform medializing, lateralizing, and Dwyer osteotomies as part of comprehensive foot reconstruction.

Explore Foot Reconstruction Options → | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Myerson MS, et al. “The Medializing Calcaneal Osteotomy for the Treatment of Adult Acquired Flatfoot Deformity.” Foot and Ankle Clinics. 2005;10(1):107-119.
2. Dwyer FC. “Osteotomy of the Calcaneum for Pes Cavus.” Journal of Bone and Joint Surgery British. 1959;41-B(1):80-86.
3. Guyton GP. “Calcaneal Osteotomies.” Foot and Ankle Clinics. 2015;20(3):451-464.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.