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 deformity where there is a decrease in or absence of the medial longitudinal arch of the foot upon weight-bearing along with hindfoot valgus, midfoot abduction and forefoot varus. 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 Evan’s 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 (FHSQ) was used to compare their preoperative and 6-month postoperative characteristics.

RESULTS

Postoperative clinical outcomes revealed that footwear scores ( = 0.002), general foot health (MD = 2.46 ± 0.72,  = 0.001), and FSHQ scores were significantly greater (MD = 2.54 ± 0.59,  = 0.001) than preoperative scores were. In addition, the postoperative talocalcaneal angle values, calcaneo-cuboid angle (CCA), talo-1st metatarsal angle, talar declination angle (TDA) and Meary’s angle were significantly lower than the preoperative values. However, talar head coverage (MD=-10.23% ± 6.80%,  < 0.001) and the calcaneal inclination angle (CIA) (MD=-9.89 ± 6.47,  < 0.001) were significantly greater postoperatively than preoperatively.

CONCLUSION

Significant clinical and radiological improvement were 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.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12891-025-08978-1.