Evans calcaneal lengthening osteotomy for treatment of symptomatic pes planovalgus in children

Objective To evaluate the results of modified Evans osteotomy technique for treatment of symptomatic pes planovalgus in children. Methods Criteria for inclusion in the study were the symptomatic patients whose loot's medial longitudinal arch was lowered or lost. Caleaneal lengthening osteotomy was performed using the modified Evans technique in 23 feet of 18 patients (11 males, 7 females) during Jan. of 2006 to Jul. of 2008, five patients had bilateral involvement. The mean followup was 2 years 5 months (range 7 months to 3 years and 3 months). All were idiopathic, and received long-term conservative therapy preoperatively. Anteroposterior and lateral radiographs of the feet with weight bearing were made at the time of presentation, immediately postoperatively, and at the time of the latest follow-up. Clinical and radiographic assessment was based on the Dogan system. Radiographic measurements obtained at these times were compared Results Radiographically, union was achieved in all the patients after 8 weeks. Clinical results were perfect in 22 feet (96%), good in one foot (4%). There were significant changes in every measured angle on the anteroposterior or lateral radiographs between the preoperation and the latest follow-up. An average of 8.0 mm (range 5 to 10 mm) of calcaneal lengthening was obtained. Malpositioning of the graft or overcorrection did not occur. All the patients restored the weight bearing of plantigrade foot. Conclusions Calcaneal lengthening osteotomy for symptomatic pes planovalgus provides pain relief and significant clinical and radiographic correction in the hind foot and forefoot. Key words: Flatfoot; Caleaneus; Osteotomy