Comparative Study between Evans Calcaneal Osteotomy and Medial Sliding Osteotomy in Adolescents with Symptomatic Flexible Flatfoot Deformity
- 1Orthopedic Surgery department, Faculty of medicine, Suez canal university, Ismailia, Egypt
- 2Orthopedic surgery department, faculty of medicine Suez canal university, Ismailia, Egypt
- 3orthopedic surgery department, faculty of medicine, suez canal university, Ismailia, Egypt
Abstract
Introduction: Flexible flatfoot is common during childhood and adolescence. Most flexible flatfeet are asymptomatic and do not require surgery; operative treatment is generally reserved for patients with persistent symptoms and a clinically significant, flexible deformity despite appropriate conservative treatment. Evans calcaneal osteotomy (lateral column lengthening and medial sliding calcaneal osteotomy address different mechanical components of the deformity. This study compared their short-term clinical and radiographic outcomes in adolescents with symptomatic flexible flatfoot. Methods: This prospective randomized comparative study included 20 adolescents aged 10–18 years with flexible flatfoot. Ten patients underwent Evans calcaneal osteotomy/lateral column lengthening (Group A) and 10 underwent medial sliding calcaneal osteotomy (Group B). Clinical assessment used the AOFAS score. Weight-bearing standing anteroposterior and lateral radiographs were assessed using the AP talo-first-metatarsal angle, lateral Meary’s angle, lateral talocalcaneal angle, and lateral calcaneal inclination angle. Patients were followed for six months. Results: There are no statistically significant between-group differences for these radiographic parameters. Mean operative time was 105±10.1 minutes for Group A and 75±10.1 minutes for Group B. Complication frequencies were low and did not differ significantly between groups.
Conclusion: Both procedures were associated with substantial short-term improvement in function and radiographic alignment. The absence of statistically significant between-group differences should not be interpreted as evidence of equivalence because the sample was small. Procedure selection should be based on the predominant deformity pattern, particularly hindfoot valgus versus forefoot abduction/lateral-column insufficiency, together with patient-specific factors
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BibTeX
@article{morssy2026comparative,
title = {{Comparative Study between Evans Calcaneal Osteotomy and Medial Sliding Osteotomy in Adolescents with Symptomatic Flexible Flatfoot Deformity}},
author = {Ahmed Morssy and Ahmed Sakr and Moawed El-Adawy and Sam Samaan},
journal = {The Egyptian Orthopaedic Journal},
year = {2026},
month = oct,
doi = {10.21608/eoj.2026.533625.1269},
url = {https://doi.org/10.21608/eoj.2026.533625.1269},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Study between Evans Calcaneal Osteotomy and Medial Sliding Osteotomy in Adolescents with Symptomatic Flexible Flatfoot Deformity
AU - Ahmed Morssy
AU - Ahmed Sakr
AU - Moawed El-Adawy
AU - Sam Samaan
PY - 2026
DA - 2026/10/01
JO - The Egyptian Orthopaedic Journal
DO - 10.21608/eoj.2026.533625.1269
UR - https://doi.org/10.21608/eoj.2026.533625.1269
AB - Introduction: Flexible flatfoot is common during childhood and adolescence. Most flexible flatfeet are asymptomatic and do not require surgery; operative treatment is generally reserved for patients with persistent symptoms and a clinically significant, flexible deformity despite appropriate conservative treatment. Evans calcaneal osteotomy (lateral column lengthening and medial sliding calcaneal osteotomy address different mechanical components of the deformity. This study compared their short-term clinical and radiographic outcomes in adolescents with symptomatic flexible flatfoot. Methods: This prospective randomized comparative study included 20 adolescents aged 10–18 years with flexible flatfoot. Ten patients underwent Evans calcaneal osteotomy/lateral column lengthening (Group A) and 10 underwent medial sliding calcaneal osteotomy (Group B). Clinical assessment used the AOFAS score. Weight-bearing standing anteroposterior and lateral radiographs were assessed using the AP talo-first-metatarsal angle, lateral Meary’s angle, lateral talocalcaneal angle, and lateral calcaneal inclination angle. Patients were followed for six months. Results: There are no statistically significant between-group differences for these radiographic parameters. Mean operative time was 105±10.1 minutes for Group A and 75±10.1 minutes for Group B. Complication frequencies were low and did not differ significantly between groups. Conclusion: Both procedures were associated with substantial short-term improvement in function and radiographic alignment. The absence of statistically significant between-group differences should not be interpreted as evidence of equivalence because the sample was small. Procedure selection should be based on the predominant deformity pattern, particularly hindfoot valgus versus forefoot abduction/lateral-column insufficiency, together with patient-specific factors
SN - 2090-9926
SN - 1110-1148
ER -