Osteotomy for CMT: What It Is and Recovery

I'm not a doctor. This guide shares my own experience of a 10-hour CMT foot reconstruction, backed by research I've referenced throughout. Always check with your surgical team before changing your diet, supplements or medication.

What an osteotomy is (plain English)

An osteotomy is simply a controlled cut through a bone to change its angle or length. In CMT foot surgery it's used to straighten bones that muscle imbalance has pulled out of line. You can read the full definition in the glossary entry for osteotomy.

Types used in CMT: calcaneal, first metatarsal, midfoot

• Calcaneal (heel) osteotomy: the heel bone is cut and shifted sideways to correct the inward (varus) tilt.
• First metatarsal osteotomy: the long bone behind the big toe is realigned to lower a peaked arch.
• Midfoot osteotomy: one or more midfoot bones are reshaped to flatten the sole so it sits flat on the ground.

How the bone is fixed: screws, plates, staples

Once the bone is moved into its new position, it has to be held there while it heals. Surgeons use screws, plates, or staples, or sometimes a combination. In my case a collection of screws, plates and staples held the new architecture together while the bones fused.

Bone healing timeline and why weight bearing waits

Bone healing happens in stages over roughly 6 to 12 weeks. For the first 6 to 8 weeks the cut is held only by the hardware and a soft callus, so you must not put weight through it. That's why you spend that time non-weight bearing in a cast. My cast came off at week 8, when X-rays confirmed the bones were fusing.

What helps bone union (vitamin D, protein, not smoking)

Bone needs raw materials to rebuild. Vitamin D3 and K2 help direct calcium into the new bone rather than your arteries. Adequate protein supplies the amino acids for the collagen scaffold. Smoking significantly slows bone healing and raises the risk of non-union, so stopping before surgery is one of the most impactful things you can do. My full supplement routine is on the nutrition page.

Pain in the early weeks: my experience

The first two weeks were the most uncomfortable, managed with elevated positioning and a carefully planned pain regimen. Because of my CMT and blood thinners, strong opioids were avoided. Things eased noticeably once the swelling came down and the cast settled.

Will the hardware come out?

Not always. Hardware is left in unless it's causing pain, sitting proud under the skin, or, as in my case, acting as a nidus for infection. When my heel became infected, the metal was removed during debridement. If it's not bothering you, many surgeons leave it in permanently.

FAQs

How long until I can walk after an osteotomy?

Usually 6 to 8 weeks non-weight bearing, then a gradual return to weight bearing in a boot over several more weeks, guided by X-rays.

Does the cut bone hurt as it heals?

The acute surgical pain eases within a couple of weeks. A deeper ache can persist as the bone remodels, but it should steadily improve.

References

• Calcaneal osteotomy technique and outcomes (NCBI)
• Cavovarus foot in Charcot-Marie-Tooth disease (NCBI)
• Bone healing and nutrition (ROC Orthopedics)