Cotton Osteotomy

Foot AnatomySurgeons use a Cotton osteotomy to correct specific foot deformities that cause flat feet by cutting into the topside of the medial cuneiform bone and prying it open before fixating it in place with a wedge-like groove that helps to push the foot into proper alignment.  Flat foot, or pes planus, collapses the arch of the foot and can cause significant pain and nerve damage over time.  Often surgeons treat flat feet with non-surgical options, but if those treatments fail then physicians consider surgical intervention.  Appropriate cases requiring a Cotton osteotomy contain bone angle deformity that bends the arch of the foot the wrong way.

candidates for a Cotton Osteotomy

Patients with flat feet that do not respond to conservative treatments can discus with their surgeon if they are candidates for arch reconstruction.  Intervention includes a cotton osteotomy as one of the many techniques for treating flat feet. Surgeons can reshape aspects of bones in the foot to correct the final shape of the patient’s arch.  This reshaping, or osteotomy, involves an outpatient procedure where the surgeon identifies and reshapes some or all the many bones of the foot to correct the arch.  Cotton Osteotomy refers to cutting and expanding a wedge in the top of the medial cuneiform bone.

The day of your Cotton Osteotomy

surgeryWe perform Cotton osteotomies on an outpatient basis with the use of anesthesia.  Patients must be healthy enough to undergo anesthesia and our practice takes patient safety very seriously.  Diabetes must be under an acceptable level of control, we require cessation of smoking, and you may have to get surgical clearance from your PCP if you are elevated risk.

The surgeon makes an incision on the dorsal side of you foot exposing the medial cuneiform bone.  Then after determining placement the surgeon cuts a slice into the bone.  Using a specialized tool called a distractor, the surgeon expands the slice creating a “V” shaped wedge to changing the angles of the bone to the desired shape.  A specialized plate holds the wedge open and after removing the distractor the surgeon fixes the plate to the bone with screws.  At this point the surgeon has stabilized the bone and prepares the site for closing.

Recovery from a Cotton Osteotomy

The patient will have a cast or a cast boot and cannot bear weight on the foot for a minimum of six weeks.  After confirming that proper healing has taken place at six weeks the patient will be able to wear a support boot and partially weight bear. Most patients have satisfactorily healed and can return to regular presurgical behavior some time between three and six months after surgery.

Considering Flat Foot reconstruction? Ask our fellowship trained foot and ankle orthopedic team if a Cotton Osteotomy is right for you! 817-375-5200

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