From the Research
A calcaneal inclination angle of 6 degrees alone is not necessarily an indication for surgery. This measurement, which is significantly lower than the normal range of 18-25 degrees, indicates a flatfoot deformity (pes planus) 1. However, surgical intervention is typically recommended only when conservative treatments have failed and the patient is experiencing significant pain or functional limitations. Conservative management should be attempted first, including custom orthotic devices, supportive footwear, physical therapy, anti-inflammatory medications, and activity modifications.
Some key points to consider in the management of a patient with a calcaneal inclination angle of 6 degrees include:
- The presence of symptoms such as pain, functional limitations, or secondary problems like tendinitis or arthritis
- The patient's overall clinical picture, including symptom severity and the presence of other foot abnormalities
- The potential benefits and risks of surgical intervention, including the possibility of complications or incomplete relief of symptoms
Surgery becomes a consideration when these measures don't provide adequate relief, especially if the patient has progressive deformity, persistent pain with daily activities, or development of secondary problems like tendinitis or arthritis. The decision for surgery should be individualized based on the patient's overall clinical picture, including symptom severity, functional limitations, and the presence of other foot abnormalities, rather than being based solely on a single radiographic measurement like the calcaneal inclination angle 2, 1.
It's also important to note that the most recent and highest quality study, which is from 2020 1, suggests that dorsal wedge calcaneal osteotomy can be an effective treatment for insertional Achilles tendinopathy in patients with a high calcaneal inclination angle, but this may not be directly applicable to a patient with a calcaneal inclination angle of 6 degrees. Therefore, a thorough evaluation of the patient's condition and individualized treatment plan is necessary to determine the best course of action.