Evaluation of Clinical and Radiological Results of Calcaneal Lengthening Osteotomy in Pediatric Idiopathic Flexible Flatfoot

Document Type : RESEARCH PAPER


1 Tehran University of Medical Science, Tehran, Iran

2 The Royal London Limb Reconstruction Service St Bartholomew’s and Royal London Hospital Barts Health NHS Trust, London, UK


Background: Flexible idiopathic flatfoot is the most common form of flatfoot. First line treatments are parental
reassurance and conservative measures; however, surgical treatment may be needed in some cases. A number
of surgical techniques with varying results have been described in the literature. Here, we present our clinical and
radiological outcomes of calcaneal lengthening osteotomy for pediatric idiopathic flexible flatfoot.
Methods: Calcaneal lengthening osteotomy was performed in 20 patients, 30 feet, with idiopathic flexible flatfoot
that were resistant to conservative treatment between 2007 and 2011. Patients were evaluated according to ACFAS
universal evaluation scoring scale and radiographic indexes. The mean follow up duration was 23.1 ± 9.9 months.
Results: The average age was 10.4 ± 0.9 years. Achilles tendon lengthening was performed in 28 feet. ACFAS score
at the final follow up had improved significantly compared to pre-operative score (37 to 88, P<0.0001). Radiographic
parameters also showed significant improvement after surgery ((P<0.0001)). Distal segment displacement and hardware
irritation as postop complications were observed in 2 and 3 cases, respectively, with no long-term clinical impact.
Conclusion: Calcaneal lengthening osteotomy is an appropriate and safe operation in symptomatic idiopathic
flexible flat foot that is resistant to conservative treatment.
Level of evidence: IV


Main Subjects

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