Calcaneal lengthening osteotomy in the treatment of flexible flatfoot in children
DOI:
https://doi.org/10.15574/PS.2025.4(89).4146Keywords:
children, flatfoot, os calcis, osteotomyAbstract
Aim - to analyze the skialogical, functional, and clinical results of calcaneal lengthening osteotomy in children with flexible flatfoot (FF).
Material and methods. The retrospective study includes 10 patients (17 cases) with FF who underwent calcaneal lengthening osteotomy by the Evans-Mosca technique. All patients had the shortening of the m. triceps surae. The age of patients ranged from 8 to 16 years (mean 12±0.7 years); there were 9 boys and 1 girl. Evaluation of the results was carried out on the dynamics of vertical and horizontal talo-1st-metatarsal angles (TMA), os calcis inclination angle (CIA), AOFAS scale (hindfoot and ankle), Foot Function Index (17-I FFI, Italian version), VAS (pain) in terms of 2 to 4 years.
Results. The operation caused a pronounced cosmetic, radiological, and functional effect. All patients and their parents were satisfied with the result of the surgery. There is an improvement in radiological parameters on average: vertical TMA from 21,9 to 1,9°; horizontal TMA from 21,1 to 3°; CIA from 6,8 to 15,3°. The dynamics of the foot function by average: increasing by AOFAS scale from 69,3 to 95,1; improvements for FFI from 14,9 to 2%; reduction of pain by VAS from 3,8 to 0,8. Effective foot extension increased from 0,5 to 8,9°. The difference between the averages was significant (p˂0,001).
Conclusion. Os calcis lengthening osteotomy is an effective operation in the treatment of symptomatic FF in children, which provides a significant reduction in pain, good clinical and radiological results. The advantages of os calcis lengthening osteotomy are simple surgical techniques and a low risk of neurovascular complications.
The study was conducted in accordance with the Declaration of Helsinki. The protocol was approved by the Local Ethics Committee. Written informed consent was obtained from the children’s legal guardians.
The authors declare no conflict of interest.
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