Skip to main content
Log in

Double calcaneal osteotomy and percutaneous tenoplasty for adequate arch restoration in adult flexible flat foot

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Treatment of adult acquired flexible flat foot deformity can be problematic. Triple arthrodesis for structural correction has been the standard of care, thus sacrificing hind foot motion. The objective of this study was to assess the value of double calcaneal osteotomies in improving structural alignment while maintaining hind foot motion, which may further protect the function of adjacent motion segments. Double calcaneal osteotomies (Evans osteotomy and posterior calcaneal displacement osteotomy) were performed on 17 feet of 14 patients. Postoperative follow-up showed significant improvement in clinical foot and ankle scores.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Goldner JL, Keats PK, Bassett FH 3rd, Clippinger FW (1974) Progressive talipes equinovalgus due to trauma or degeneration of the posterior tibial tendon and medial plantar ligaments. Orthop Clin North Am 5:39–51

    PubMed  CAS  Google Scholar 

  2. Funk DA, Cass JR, Johnson KA (1986) Acquired adult flat foot secondary to posterior tibial-tendon pathology. J Bone Joint Surg Am 68:95–102

    PubMed  CAS  Google Scholar 

  3. Mann RA (1999) Flatfoot in adults. In: Mann RA, Coughlin MJ (eds) Surgery of the foot and ankle, 7th edn. Mosby, St. Louis, pp 733–767

    Google Scholar 

  4. Arangio GA, Phillippy DC, Xiao D, Gu WK, Salathe EP (2000) Subtalar pronation—relationship to the medial longitudinal arch loading in the normal foot. Foot Ankle Int 21:216–220

    PubMed  CAS  Google Scholar 

  5. Arangio GA, Chopra V, Voloshin A, Salathe EP (2007) A biomechanical analysis of the effect of lateral column lengthening calcaneal osteotomy on the flat foot. Clin Biomech (Bristol, Avon) 22:472–477

    Article  Google Scholar 

  6. Fowble VA, Sands AK (2007) Treatment of adult acquired pes plano abductovalgus (flatfoot deformity): procedures that preserve complex hindfoot motion. Oper Techn Orthop 14:13–20

    Article  Google Scholar 

  7. Lee MS, Vanore JV, Thomas JL et al (2005) Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg 44:78–113

    Article  PubMed  Google Scholar 

  8. Frankel JP, Turf RM, Kuzmicki LM (1995) Double calcaneal osteotomy in the treatment of posterior tibial tendon dysfunction. J Foot Ankle Surg 34:254–261

    Article  PubMed  CAS  Google Scholar 

  9. Tryfonidis M, Jackson W, Mansour R et al (2008) Acquired adult flat foot due to isolated plantar calcaneonavicular (spring) ligament insufficiency with a normal tibialis posterior tendon. Foot Ankle Surg 14:89–95

    Article  PubMed  CAS  Google Scholar 

  10. Marks RM, Long JT, Ness ME, Khazzam M, Harris GF (2009) Surgical reconstruction of posterior tibial tendon dysfunction: prospective comparison of flexor digitorum longus substitution combined with lateral column lengthening or medial displacement calcaneal osteotomy. Gait Posture 29:17–22

    Article  PubMed  Google Scholar 

  11. Guyton GP, Jeng C, Krieger LE, Mann RA (2001) Flexor digitorum longus transfer and medial displacement calcaneal osteotomy for posterior tibial tendon dysfunction: a middle-term clinical follow-up. Foot Ankle Int 22:627–632

    PubMed  CAS  Google Scholar 

  12. Banks AS, McGlamry ED (1987) Tibialis posterior tendon rupture. J Am Podiatr Med Assoc 77:170–176

    PubMed  CAS  Google Scholar 

  13. Mann RA (1983) Acquired flatfoot in adults. Clin Orthop Relat Res 181:46–51

    PubMed  Google Scholar 

  14. Catanzariti AR, Lee MS, Mendicino RW (2000) Posterior calcaneal displacement osteotomy for adult acquired flatfoot. J Foot Ankle Surg 39:2–14

    Article  PubMed  CAS  Google Scholar 

  15. Sangeorzan BJ, Mosca V, Hansen ST Jr (1993) Effect of calcaneal lengthening on relationships among the hindfoot, midfoot, and forefoot. Foot Ankle 14:136–141

    PubMed  CAS  Google Scholar 

  16. Kitaoka H, Alexander I, Adelaar R et al (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353

    PubMed  CAS  Google Scholar 

  17. van der Krans A, Louwerens JW, Anderson P (2006) Adult acquired flexible flatfoot, treated by calcaneocuboid distraction arthrodesis, posterior tibial tendon augmentation, and percutaneous Achilles tendon lengthening: a prospective outcome study of 20 patients. Acta Orthop 77:156–163

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abdel-Rahman El-Ganainy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Basioni, Y., El-Ganainy, AR. & El-Hawary, A. Double calcaneal osteotomy and percutaneous tenoplasty for adequate arch restoration in adult flexible flat foot. International Orthopaedics (SICOT) 35, 47–51 (2011). https://doi.org/10.1007/s00264-010-1071-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-010-1071-z

Keywords

Navigation