We aimed to assess the effects of medial displacement calcaneal osteotomy (MDCO) through
a minimal skin incision in terms of pain, function, and alignment in patients with
unilateral adult acquired flatfoot. American Orthopedic Foot and Ankle Society (AOFAS)
hindfoot scale and Numeric Pain Rating Scale (NPRS) were assessed as outcomes at the
baseline (T0), at 6 months (T1), and at 1 year (T2) from surgery. We analyzed data
of 20 patients (7 male and 13 female), mean aged 46.6±5.34 years, showed significant
differences after 6 months in terms of AOFAS total score (44.30±7.39 vs 96.50±4.89;
p=0.0001), AOFAS subitems (p<0.001), and pain (NPRS: 7.95±1.36 vs 1.05±1.05; p=0.0001).
At 1 year after surgery (T2) all outcome measures still significantly differ from
baseline (p<001). Therefore, percutaneous MDCO through a minimal skin incision seemed
to be safe and effective in the middle and long-term in reducing pain and improving
function and alignment in patients with unilateral adult acquired flatfoot.
Level of Clinical Evidence
To read this article in full you will need to make a payment
Adult-acquired flatfoot deformity.
J Am Acad Orthop Surg. 2008; 16: 399-406https://doi.org/10.5435/00124635-200807000-00005
Calcaneal osteotomies for the treatment of adult-acquired flatfoot.
Clin Podiatr Med Surg. 2007; 24: 699-719
Classifications in Brief: Johnson and Strom Classification of Adult-acquired Flatfoot Deformity.
Clin Orthop Relat Res. 2016; 474: 588-593https://doi.org/10.1007/s11999-015-4581-6
Posterior tibial tendon rupture: a refined classification system.
Foot Ankle Clin. 2007; 12: 233-249https://doi.org/10.1016/j.fcl.2007.03.003
Nonoperative Management of Adult Flatfoot Deformities.
Clin Podiatr Med Surg. 2014; 31: 337-347
Curr Rev Musculoskelet Med. 2014; 7: 271-276https://doi.org/10.1007/s12178-014-9237-8
Symposium: adult acquired flatfoot deformity.
Foot Ankle Int. 2011; 32: 95-111https://doi.org/10.3113/FAI.2011.0095
Outcomes of Reconstruction of the Flexible Adult-acquired Flatfoot Deformity.
Orthop Clin North Am. 2020; 51: 109-120https://doi.org/10.1016/j.ocl.2019.08.005
Treatment of mobile flat foot by displacement osteotomy of the calcaneus.
J Bone Joint Surg Br. 1971; 53: 96-100
Minimally Invasive Osteotomies of the Calcaneus.
Foot Ankle Clin. 2016; 21: 551-566https://doi.org/10.1016/j.fcl.2016.04.007
Adult-Acquired Flatfoot Deformity: Etiology, Diagnosis, and Management.
JBJS Rev. 2017; 5: e7https://doi.org/10.2106/JBJS.RVW.16.00116
Adult Acquired Flatfoot Deformity: Anatomy, Biomechanics, Staging, and Imaging Findings.
Radiographics. 2019; 39: 1437-1460https://doi.org/10.1148/rg.2019190046
American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity.
J Foot Ankle Surg. 2020; 59: 347-355https://doi.org/10.1053/j.jfas.2019.09.001
Talonavicular joint arthrodesis and Evans calcaneal osteotomy for treatment of posterior tibial tendon dysfunction.
J Foot Ankle Surg. 1999; 38: 116-122https://doi.org/10.1016/s1067-2516(99)80022-2
A biomechanical analysis of posterior tibial tendon dysfunction, medial displacement calcaneal osteotomy and flexor digitorum longus transfer in adult acquired flat foot.
Clin Biomech (Bristol, Avon). 2009; 24: 385-390https://doi.org/10.1016/j.clinbiomech.2009.01.009
Surgical Management of Stage 2 Adult and Pediatric Acquired Flatfoot Without Tendon Transfer or Arthrodesis: A Retrospective Study.
J Foot Ankle Surg. 2018; 57: 658-663https://doi.org/10.1053/j.jfas.2017.11.036
Outcome of medial displacement calcaneal osteotomy for correction of adult-acquired flatfoot.
Foot Ankle Int. 2012 Nov; 33 (10.3113): 940-946
Complications of minimally invasive calcaneal osteotomy versus open osteotomy.
Foot Ankle Int. 2015; 36: 685-690https://doi.org/10.1177/1071100715571438
Medial displacement calcaneal osteotomy using minimally invasive technique.
Foot Ankle Int. 2015; 36: 248-252https://doi.org/10.1177/1071100714557154
Treating haglund’s deformity with percutaneous achilles tendon decompression: A case series.
Muscles Ligaments Tendons J. 2019; 8: 488-494https://doi.org/10.32098/mltj.04.2018.05
Italian translation, cultural adaptation and validation of the « American Orthopaedic Foot and Ankle Society’s (AOFAS) ankle-hindfoot scale ».
Acta Biomed. 2016; 87: 38-45
Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.
Foot Ankle Int. 1994; 15: 349-353
Reliability and validity of the subjective component of the American Orthopaedic Foot and Ankle Society clinical rating scales.
J Foot Ankle Surg. 2007; 46: 65-74
PROMIS Pain Interference Is Superior vs Numeric Pain Rating Scale for Pain Assessment in Foot and Ankle Patients.
Foot Ankle Int. 2019; 40: 139-144https://doi.org/10.1177/1071100718803314
EuroQol–a new facility for the measurement of health-related quality of life.
Health Policy. 1990; 16: 199-208
The Flexible Adult Flatfoot.
Clin Podiatr Med Surg. 2014; 31: 329-336https://doi.org/10.1016/j.cpm.2014.03.005
Consensus for the Indication of a Medializing Displacement Calcaneal Osteotomy in the Treatment of Progressive Collapsing Foot Deformity.
Foot Ankle Int. 2020 Aug 26; (Online ahead of print)https://doi.org/10.1177/1071100720950747
Procedure selection for the flexible adult acquired flatfoot deformity.
Clin Podiatr Med Surg. 2014; 31: 363-379https://doi.org/10.1016/j.cpm.2014.03.003
Calcaneal osteotomy in the treatment of adult acquired flatfoot deformity.
Foot Ankle Clin. 2012; 17: 247-258https://doi.org/10.1016/j.fcl.2012.02.003
Effects of Medial Displacement Calcaneal Osteotomy and Calcaneal Z Osteotomy on Subtalar Joint Pressures: A Cadaveric Flatfoot Model.
J Foot Ankle Surg. 2016; 55: 1175-1179https://doi.org/10.1053/j.jfas.2016.07.009
Medial Displacement Calcaneal Osteotomy: A Comparison of Screw Versus Locking Plate Fixation.
J Foot Ankle Surg. 2016; 55: 1164-1168https://doi.org/10.1053/j.jfas.2016.06.006
In Press Accepted Manuscript
Published by Elsevier Inc. on behalf of the American College of Foot and Ankle Surgeons.
Access this article on ScienceDirect