Cotton Osteotomy
Cotton Osteotomy
The Cotton osteotomy, a medial cuneiform dorsal opening wedge osteotomy, is used to treat various foot deformities such as collapsing pes planovalgus, metatarsus primus elevatus, overcorrected clubfoot, and forefoot varus, often as an adjunct to hindfoot reconstruction for a plantigrade foot. In a Cotton osteotomy, an allograft bone wedge can be used to correct the deformity, typically a flatfoot condition or forefoot varus deformity.
- The study presents a retrospective review of Cotton osteotomy as an adjunctive procedure in flatfoot reconstructive surgery, demonstrating its effectiveness in correcting forefoot varus deformity. A tricortical wedge cut from an iliac crest was press-fit into an osteotomy created in the medial cuneiform, successfully serving as a structural support and promoting proper alignment.
- This study presents the case of a successful Cotton osteotomy on an adolescent patient, emphasizing the use of allografts and an innovative nerve-centric incision design. The use of allografts in the Cotton osteotomy has been shown to achieve similar union rates to autografts, demonstrating their efficacy in the procedure, and their suitability is further exemplified by the absence of complications such as nonunion, graft failure, infection, or reoperation in published reports.