Radiological Evaluation Of Lateral Calcaneal Lengthening and Tibialis Posterior Advancement in Flexible Flat Foot | ||||
| Medicine Updates | ||||
| Articles in Press, Accepted Manuscript, Available Online from 03 August 2025 PDF (780.48 K) | ||||
| Document Type: Research project | ||||
| DOI: 10.21608/muj.2025.409668.1243 | ||||
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| Authors | ||||
Raouf Ramadan El Naggar  1; khaled sabry Sabry Salama1; Amin Abdel Razek Abdel Razek Youssef2; Mohammed El Tabee EL Greatly1; Mohamed Abdel Aziz Sabry Fayed1
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| 1Orthopedic department, faculty of medicine, Port Said University, port Said, Egypt | ||||
| 2Orthopedic department, Faculty of Medicine. Alexandria University | ||||
| Abstract | ||||
| Absatrct Background: Flexible flat foot (FFF) is a common pediatric condition typified by forefoot abduction, hindfoot valgus, and medial arch collapse when bearing weight. In symptomatic cases unresponsive to conservative management, surgical intervention is warranted. Objective: To assess the radiological results of tibialis posterior tendon (TPT) and lateral calcaneal lengthening osteotomy advancement in managing symptomatic flexible flat foot in skeletally immature patients. Methods: Twenty feet from children receiving treatment at El Nasr Specialized Hospital in Port Said for idiopathic flexible flatfoot symptoms were included in this prospective interventional trial. All cases underwent lateral calcaneal lengthening with iliac crest bone graft insertion and TPT advancement under general anesthesia. Anteroposterior (AP) and lateral foot images evaluating the talonavicular (TN) covering angle, talo–first metatarsal (T1stMT) angle, calcaneal pitch, and talocalcaneal (TC) angle were part of the preoperative and postoperative radiographic evaluations. Results: The mean age was 9.6 ± 1.6 years; 60% were male. Bilateral involvement was noted in 88% of cases. Postoperative radiographs demonstrated significant improvement across all measured parameters. TN coverage angle decreased from 26.2° ± 4.9° to 7.5° ± 4.1° (p < 0.001), T1stMT angle from 18.6° ± 4.3° to 7.4° ± 1.9° (p < 0.001), The calcaneal pitch went raised from 11.2° ± 1.4° to 20.1° ± 2.8° (p < 0.001), and TC angle reduced from 45.6° ± 2.2° to 39.2° ± 3.1° (p < 0.001). Conclusion: The combined surgical technique significantly improves radiological alignment in pediatric flexible flat foot and is a reliable option when conservative treatments fail. | ||||
| Keywords | ||||
| Flexible flatfoot; Calcaneal lengthening; Tibialis posterior; Pediatric foot surgery; Radiological outcome | ||||
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