{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:33:40Z","timestamp":1793730820279,"version":"4.6.1"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Orthopaedics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There has been increasing interest in the percutaneous dorsal closing-wedge Zadek calcaneal osteotomy (PDCWZO) for the treatment of insertional Achilles tendinopathy (IAT). This study aims to investigate the clinical efficacy and radiographic outcomes of the percutaneous dorsal closing-wedge Zadek calcaneal osteotomy in patients with and without pes cavus foot morphology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicentre observational study of patients undergoing PDCWZO for IAT. Patients were stratified into cavus (calcaneal pitch angle\u2009&gt;\u200920 degrees) and non-cavus (calcaneal pitch angle\u2009\u2264\u200920 degrees) groups. The primary outcome was the X\/Y ratio and calcaneal pitch angle. Clinical outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ), visual analogue scale (VAS) for pain, and EuroQol\u20135 dimensions (EQ-5D). Between-group analyses were performed to identify differences in outcomes based on foot morphology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Between April 2022 and December 2024, 67 feet (61 patients; 25 male, 36 female) with mean age 55.0\u2009\u00b1\u200912.7\u2009years (range: 20.9-77.6) underwent percutaneous Zadek osteotomy with a median clinical follow-up of 0.56\u2009years (IQR: 0.48-0.99) and median radiographic follow-up of 0.36\u2009years (IQR: 0.13-0.49). The cohort included 50 cavus feet and 17 non-cavus feet. Radiographic analysis showed a significant increase in the X\/Y ratio in both groups (cavus: 2.44\u2009\u00b1\u20090.27 to 3.08\u2009\u00b1\u20090.45,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001; non-cavus: 2.43\u2009\u00b1\u20090.28 to 3.05\u2009\u00b1\u20090.56,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Calcaneal pitch angle remained unchanged in both the cavus group (27.1\u2009\u00b1\u20094.2 degrees to 27.1\u2009\u00b1\u20094.6 degrees,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.917) and non-cavus group (17.7\u2009\u00b1\u20091.7 degrees to 18.8\u2009\u00b1\u20094.8 degrees,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.270). Clinical outcomes in all groups demonstrated significant improvement in all MOXFQ domains, VAS Pain and EQ-5D (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). The complication rate was 6.0%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>At short-term follow-up (median 6.7\u2009months), percutaneous Zadek calcaneal osteotomy demonstrated a low complication rate and was associated with improvements in foot function and pain relief for patients with both cavus and non-cavus feet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective comparative study.<\/jats:p>\n                  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