Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: A retrospective investigation

Objective : Flexible flat foot deformity refers to a decrease in or absence of the medial longitudinal arch of the foot upon weight-bearing. Evan’s calcaneal osteotomy is a standard procedure used globally to correct deformities when clinically indicated, but its qualitative clinical and radiological outcomes have rarely been discussed. This study aimed to examine patients’ quality of life and radiological improvement after Evan’s osteotomy. Methods : Data were obtained retrospectively from the orthopedic database of Jordan University Hospital, including a total of 27 patients between the ages of 8 and 23 years who underwent Evans calcaneal osteotomy for flexible flatfoot deformity within the specified period (2017- - 2021). Eight radiological parameters were used to assess and compare X-rays, while the foot health status questionnaire was used to compare their preoperative and postoperative characteristics. Results : Postoperative clinical outcomes revealed that footwear scores (p=0.002), general foot health (MD=2.46 ± 0.72, p=0.001), and FSHQ scores were significantly greater (MD=2.54 ± 0.59, p=0.001) than preoperative scores were. In addition, the postoperative talocalcaneal angle values, CCA, talo-1 ^st metatarsal angle, TDA and Meary’s angle were significantly lower than the preoperative values. However, talar head coverage (MD=-10.23% ± 6.80%, p<0.001) and the CIA (MD=-9.89 ± 6.47, p<0.001) were significantly greater postoperatively than preoperatively. Conclusion : Significant clinical and radiological improvement was achieved with Evan’s osteotomy. This is very important for providing physicians with concrete qualitative data when surgery is indicated for symptomatic patients and highlights the importance of performing a meticulous surgical technique addressing all aspects of the pathology for a better outcome.