• 1

    Groner TW, DiDomenico LA: Midfoot osteotomies for the cavus foot. Clin Podiatr Med Surg 22: 247, 2005.

  • 2

    Gordon JE, Luhmann SJ, Dobbs MB, et al.: Combined midfoot osteotomy for severe forefoot adductus. J Pediatr Orthop 23: 74, 2003.

  • 3

    Dierauer S, Schäfer D, Hefti F: Osteotomies in the midfoot and the calcaneal part of the foot in relapsed clubfoot. Orthopade 28: 117, 1999.

    • Search Google Scholar
    • Export Citation
  • 4

    Lamm BM, Gourdine-Shaw MC, Thabet AM, et al.: Distraction osteogenesis for complex foot deformities: Gigli saw midfoot osteotomy with external fixation. J Foot Ankle Surg 53: 567, 2014.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 5

    Balaji G, Arokiaraj J, Nithyananth M, et al.: Complex post traumatic foot deformities: outcomes after corrective surgery. J Clin Orthop Trauma 11: 432, 2020.

  • 6

    d’Astorg H, Rampal V, Seringe R, et al.: Is non-operative management of childhood neurologic cavovarus foot effective? Orthop Traumatol Surg Res 102: 1087, 2016.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7

    Paley D, Tetsworth K: Percutaneous osteotomies: osteotome and Gigli saw techniques. Orthop Clin North Am 22: 613, 1991.

  • 8

    Conti SF, Roukis TS: Corrective ankle osteotomies. Clin Podiatr Med Surg 21: 353, 2004.

  • 9

    Roukis TS: Corrective ankle osteotomies. Clin Podiatr Med Surg 21: 353, 2004.

  • 10

    Wardak MM, Wardak E: Percutaneous Gigli saw osteotomy. Oper Orthop Traumatol 22: 414, 2010.

  • 11

    Stapleton JJ, DiDomenico LA, Zgonis T: Corrective midfoot osteotomies. Clin Podiatr Med Surg 25: 681, 2008.

  • 12

    De Bastiani G, Aldegheri R, Renzi-Brivio L, et al.: Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7: 129, 1987.

  • 13

    Paktis AS, Gross RH: Afghan percutaneous osteotomy. J Pediatr Orthop 13: 531, 1993.

  • 14

    Paley D: The correction of complex foot deformities using Ilizarov’s distraction osteotomies. Clin Orthop Relat Res 293: 97, 1993.

  • 15

    Kliushin NM, Sudnitsyn AS, Subramanyam KN, et al.: Management of neurologic deformity of the ankle and foot with concurrent osteomyelitis with the Ilizarov method. Foot Ankle Int 39: 226, 2018.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 16

    De Prado M: Minimally invasive foot surgery: a paradigm shift. Minim Invasive Surg Foot Ankle 1: 3, 2011.

  • 17

    Kojimoto H, Yasui N, Goto T, et al.: Bone lengthening in rabbits by callus distraction: the role of periosteum and endosteum. J Bone Joint Surg Br 70: 543, 1988.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Eralp L, Kocaoglu M, Özkan K, et al.: A comparison of two osteotomy techniques for tibial lengthening. Arch Orthop Trauma Surg 124: 298, 2004.

  • 19

    Sen C, Kocaoğlu M, Dinçyürek H, et al.: The reliability of percutaneous osteotomy with the Gigli saw technique in the proximal tibia: a cadaveric study. Acta Orthop Traumatol Turc 36: 136, 2002.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Li S, Chien S, Brånemark P: Heat shock-induced necrosis and apoptosis in osteoblasts. J Orthop Res 17: 891, 1999.

  • 21

    Eidelman M, Katzman A, Zaidman M, et al.: Deformity correction using supramalleolar Gigli saw osteotomy and Taylor spatial frame: how to perform this osteotomy safely? J Pediatr Orthop B 20: 318, 2011.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 22

    Ha J, Hester T, Foley R, et al.: Charcot foot reconstruction outcomes: a systematic review. J Clin Orthop Trauma 11: 357, 2020.

  • 23

    Wrotslavsky P, Kriger SJ, Hammer-Nahman SM, et al.: Computer-assisted gradual correction of Charcot foot deformities: an in-depth evaluation of stage one of a planned two-stage approach to Charcot reconstruction. J Foot Ankle Surg 59: 841, 2020.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation

Efficacy and Reliability of Percutaneous Gigli Saw Osteotomy in Midfoot Surgery: A Cadaver Study

Muharrem KanarDepartment of Orthopaedics and Traumatology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

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Rodi ErtogrulYedikule Surp Pirgic Armenian Hospital, İstanbul, Turkey.

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Yunus OcBağcılar Hospital, İstanbul, Turkey.

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Elif Nedret KeskinözDepartment of Anatomy, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey.

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Bekir Eray KilincDepartment of Orthopaedics and Traumatology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.

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Background: Midfoot osteotomy is often used in the surgical treatment of foot deformities. The percutaneous Gigli saw osteotomy (PGSO) technique has many advantages compared with known osteotomy techniques. We aimed to show the efficacy and reliability of the PGSO technique in the midfoot of fresh frozen cadavers without using an image intensifier.

Methods: Four mini-incisions were performed on the dorsomedial, dorsolateral, plantar medial, and plantar lateral regions of the midfoot. Subperiosteal tunnels were then opened with a thin bone elevator, and the four incisions were combined with each other. The Gigli saw was tied to suture material and passed through the tunnels. The PGSO was performed in the midfoot of 12 feet of the cadaver specimens without using an image intensifier. Cadaver specimens were dissected, and injured structures were noted.

Results: The mean ± SD (range) cadaver age was 81.16 ± 10.38 years (65–93 years) and weight was 60.86 ± 12.39 kg (49.8–81.6 kg). All of the osteotomies were adequate as planned in the cuboid-cuneiform level and all of them were complete osteotomy .Incomplete osteotomy was not observed in any cadaver specimens. In one specimen, a complete injury of the peroneal tendons (peroneus longus and brevis) was detected. In another specimen, an incomplete tibialis anterior tendon injury was detected. There was no iatrogenic neurovascular injury in the specimens.

Conclusions: The PGSO technique is recommended for use even by inexperienced surgeons owing to its minimal risk of soft-tissue injury, provision of a complete osteotomy line, and easy application with limited incisions.

Corresponding author: Muharrem Kanar, MD, Department of Orthopaedics and Traumatology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, 19 Mayıs Mh. Etfal Sk. Şişli Etfal EAH. Şişli İstanbul, 34371 Turkey. (E-mail: dr.kanar@hotmail.com)