title: Central calcaneal osteotomy for correction of flexible pes planovalgus deformity.
abstract: BACKGROUND
  Lateral column lengthening procedures have been extensively reported either as primary procedures or adjuncts to combined soft tissue procedures and osteotomies for the correction of the pes planovalgus deformity. There is also considerable debate as to the ideal procedure that is not followed by recurrence and obviates the need for revision surgeries and minimizes complications. We describe a technique and present the clinical results of lateral column lengthening that provides a powerful correction to restore normal foot alignment.
  
  
  METHODS
  We retrospectively reviewed 26 feet in 21 patients with a mean age of 35.4 years (range, 12-75) over an average follow-up period of 71 months (range, 12-147) who underwent reconstructive surgery for flexible pes planovalgus foot. The reconstructive procedures included a central calcaneal osteotomy in all patients, a medial column stabilization procedure, flexor digitorium transfer (FDL), and a gastrocnemius or Achilles tendon lengthening. Clinical evaluation was carried out with the AOFAS ankle-hindfoot scores. Standard weight-bearing anterior posterior (AP) and lateral radiographs before surgery and at follow-up were analyzed for radiographic parameters of correction.
  
  
  RESULTS
  The median AOFAS score increased from 50 to 90. Two patients reported dissatisfaction with the result. There were no nonunions nor complications related to hardware. Radiographic improvement of the talonavicular coverage angle was a 74% change from baseline value. All radiographic parameters improved (P < .001) except the lateral talocalcaneal angle (P = .48). No secondary subsidence of the arch was observed within the follow-up time.
  
  
  CONCLUSIONS
  Correction of flexible pes planovalgus deformity with a central calcaneal osteotomy was an effective, reproducible method to restore normal foot alignment and good function.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Reparto di Chirurgia Ortopedica, Clinica Luganese Moncucco, Lugano, Switzerland. k.klaue@bluewin.ch
authors.forename: Kaj
authors.initials: K
authors.lastname: Klaue
authors.forename: Kannan
authors.initials: K
authors.lastname: Kaliyaperumal
authors.forename: Scott A
authors.initials: SA
authors.lastname: Swanson
authors.forename: Wilson Cong Jin
authors.initials: WC
authors.lastname: Low
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods* / Q000706:statistics & numerical data; D011859:Radiography; D012189:Retrospective Studies
keywords: calcaneus; coxa pedis; flat foot; osteotomy; posterior tibial tendon