Lateral calcaneal lengthening osteotomy versus double Calcaneal osteotomy for Treatment of Symptomatic Flexible Flat Feet in Children: A Systematic Review/Meta-Analysis

Abstract

Flexible flatfoot is a very common foot and ankle disorder. There is loss medial longitudinal arch and associated valgus hind foot and abduction of the forefoot. Most children are born with flatfoot, most of these cases resolve spontaneously between two and six years of age. However, some cases do not show any spontaneous correction. Objective: This systematic review of literature and meta-analysis is conducted to compare between the outcomes of Evans osteotomy and double calcaneal osteotomy, both clinically and radiologically. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2019. Data Extraction: If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion: Evans osteotomy and double calcaneal osteotomy have shown comparable clinical and radiological improvement in treatment of idiopathic flexible flat feet in children and adolescent. Evans group had slightly higher complication rates than DCO although postoperative persistent pain is higher in DCO Few number of articles are available about both techniques and all of them are single-arm clinical trials, so the current findings can only be regarded as observations. Further randomized controlled trials with large number of patients are recommended to determine if one technique is more effective or safer than the other.