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Evans Calcaneal Osteotomy: Assessment of Multiplanar Correction
Bradley M Lamm1, Jessica Knight2, Jordan J Ernst3
1Chief of Foot & Ankle Surgery, Director, Foot & Ankle Deformity Center, Director, Foot & Ankle Deformity Correction Fellowship, The Paley Institute at St. Mary's Medical Center and Palm Beach Children's Hospital, West Palm Beach, FL.
The Evans calcaneal osteotomy effectively corrects flatfoot deformity by improving hindfoot alignment in multiple planes. This surgical procedure demonstrates significant radiographic improvements, offering a valuable solution for complex foot conditions.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Reconstruction
- Radiographic Analysis
Background:
- Flatfoot deformity involves medial arch collapse, forefoot abduction, and hindfoot valgus.
- Current surgical options lack objective data quantifying multiplanar correction.
- The Evans calcaneal osteotomy is a common procedure for flatfoot correction.
Purpose of the Study:
- To objectively quantify the multiplanar hindfoot alignment correction achieved by the Evans calcaneal osteotomy.
- To assess the radiographic outcomes of lateral column lengthening in flatfoot deformity.
- To provide reproducible measurements of structural correction after Evans osteotomy.
Main Methods:
- Retrospective review of 45 Evans calcaneal osteotomies in 40 patients.
- Analysis of radiographic measurements including calcaneal inclination angle and tibial-calcaneal angles.
- Evaluation of anteroposterior talo-first metatarsal angle and hindfoot valgus correction.
Main Results:
- Statistically significant improvements were observed in calcaneal inclination angle, tibial-calcaneal angle, tibial-calcaneal position, and AP talo-first metatarsal angle (p < .0001).
- A mean hindfoot valgus correction of 12.6° was noted.
- While graft size did not directly correlate with angular correction, clinical relevance was observed.
Conclusions:
- The Evans calcaneal osteotomy provides multiplanar correction of hindfoot alignment in flatfoot deformity.
- Radiographic measurements confirm the effectiveness of this procedure in addressing complex foot deformities.
- This study supports the Evans osteotomy as a reliable method for correcting hindfoot alignment.
