Lateral Column Lengthening (Evans Osteotomy) for Adult Acquired Flatfoot

Overview

This surgical procedure is used to modify the shape of the foot, creating an arch to correct the condition of pes planus (commonly called flat foot or fallen arch). It can dramatically change the shape of the foot, giving the foot a more normal appearance.

Preparation

In preparation for this procedure, the patient is positioned and anesthesia is administered. The surgeon then creates an incision on the outer side of the foot to access the calcaneus (commonly called the heel bone).

Cutting the Bone

The surgeon uses a cutting instrument to carefully divide the calcaneus just behind the joint where it meets the cuboid bone of the midfoot. The two pieces of the calcaneus are spread apart, and a metal or bone graft wedge is inserted between them. The bone graft may be created from bone taken from the patient's hip, or it may be fashioned from bone taken from a donor. This wedge lengthens the outer side of the foot, and in doing so creates an arch on the foot's inner side.

Stabilizing the Calcaneus

Once the bones have been aligned properly, the surgeon locks the bone graft in place with a plate and screws. Over time, the graft will fuse into the calcaneus.

End of Procedure and Aftercare

When the procedure is complete, the incision is closed and the foot is bandaged. The foot is placed in a cast for six to twelve weeks. After that time, a walking boot may be needed.

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