Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Township, MI
Last reviewed: May 2026
The Dwyer osteotomy corrects hindfoot varus by closing a lateral wedge in the calcaneus — and whether the correction is adequate without a concurrent peroneal tendon lengthening depends on the specific degree of varus measured preoperatively. Call (810) 206-1402 — expert podiatric care across Michigan.
The Dwyer osteotomy is a closing wedge calcaneal osteotomy that corrects hindfoot varus — an inverted heel position associated with cavus foot (high arch), residual clubfoot deformity, and Charcot-Marie-Tooth disease. By removing a lateral wedge of bone from the calcaneus, the heel is shifted from inversion to a neutral or slight valgus position, redistributing weight from the lateral foot and reducing ankle sprain risk.
Dwyer Osteotomy vs. Other Calcaneal Osteotomies
| Procedure | Direction | Deformity Corrected | Primary Indication |
|---|---|---|---|
| Dwyer (lateral closing wedge) | Lateral wedge removed; heel shifts to valgus | Hindfoot varus; lateral overload | Cavus foot; residual clubfoot varus; CMT hindfoot varus |
| Medializing calcaneal osteotomy (Evans-type) | Calcaneus shifted medially | Hindfoot valgus; flatfoot | PTTD stage II flatfoot reconstruction |
| Lateral column lengthening (Evans osteotomy) | Lateral calcaneus lengthened with graft | Abduction of midfoot; flatfoot | PTTD stage II; pediatric flatfoot |
| Dwyer + plantar fascia release | Varus correction + fascia release | Hindfoot varus + plantarflexed first ray | Cavovarus foot with tight plantar fascia; CMT; idiopathic cavus |
| Z-osteotomy / slide osteotomy | Calcaneal body translated in coronal plane | Both varus and valgus depending on direction | Severe deformity requiring large correction |
Dwyer Osteotomy Recovery and Outcomes
| Phase | Timeframe | Weight Bearing | Expected Outcomes |
|---|---|---|---|
| Non-weight bearing cast | Week 0-6 | Non-weight bearing; short leg cast or splint | Bone healing across osteotomy site; wound healing |
| Partial weight bearing | Week 6-8 | Partial WB in cam boot; progress per X-ray | Callus formation visible on X-ray; pain decreasing |
| Full WB and PT | Week 8-12 | Full WB in shoe with orthotic | Gait training; proprioception; strength; ankle stability work |
| Return to activity | Month 4-6 | Progressive return; hiking by 4-6 months | Improved lateral foot loading; reduced lateral ankle sprain frequency |
| Long-term outcomes | 1 year+ | Normal activity with appropriate footwear | 75-85% patient satisfaction; reduced lateral overload; ankle stability improved |
At Balance Foot & Ankle in Howell and Bloomfield Township, we evaluate cavovarus foot deformity and perform hindfoot osteotomies including the Dwyer procedure when appropriate, often combined with plantar fascia release and tendon transfers. Call (810) 206-1402.
American Academy of Orthopaedic Surgeons: Cavus Foot Surgery
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Doctor Answer
What is a Dwyer osteotomy and when is it performed?
The Dwyer osteotomy is a closing wedge procedure on the lateral calcaneus that corrects hindfoot varus alignment commonly seen with cavus foot deformity. By removing a lateral bone wedge, I shift the heel from varus into neutral position, improving weight distribution and reducing lateral ankle instability. It is frequently combined with peroneal tendon repair, plantar fascia release, and metatarsal osteotomies for comprehensive cavus foot correction.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.
More questions patients ask
What is the Dwyer osteotomy?
The Dwyer osteotomy is a closing lateral wedge osteotomy of the calcaneus that corrects hindfoot varus (inversion) deformity. It is used in cavovarus foot reconstruction, Charcot-Marie-Tooth disease, and other neurological conditions causing high arch with heel inversion.
When is a Dwyer osteotomy performed?
It is indicated for symptomatic cavovarus foot deformity with flexible hindfoot varus. It is typically combined with plantar fascia release, peroneal tendon reconstruction, and sometimes metatarsal osteotomies for a complete cavovarus correction.
What are the risks of Dwyer osteotomy?
Sural nerve injury (the nerve runs close to the surgical site), undercorrection or overcorrection of heel alignment, wound healing problems, and nonunion (uncommon with proper fixation). Results are generally excellent when combined with addressing all components of the cavovarus deformity.
Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.