Treatment of Flexible Flat Foot by Calcaneal Lengthening Using PEEK Cage | ||
The Egyptian Orthopaedic Journal | ||
Articles in Press, Accepted Manuscript, Available Online from 21 October 2025 | ||
Document Type: Original Article | ||
DOI: 10.21608/eoj.2025.429198.1091 | ||
Authors | ||
Hassan Saeed Mohammed Al-Ghoul* 1; Emad Esmat2; Ahmed El kady3 | ||
1M.B.B.Ch, Orthopedic Surgery Department, Faculty of Medicine, Benha University, Benha, Egypt | ||
2Orthopedic Surgery Department, Faculty of Medicine, Benha University, Benha, 13511, Egypt | ||
3Orthopedic Surgery Department, Faculty of Medicine, Benha University, Benha, Egypt | ||
Abstract | ||
Abstract Background: The flatfoot is a condition characterized by the flattening of the medial longitudinal arch, which adversely affects foot function and biomechanics. The aim of this study was to evaluate the outcomes of surgical treatment of Flexible Flat Foot through calcaneal lengthening using a PEEK cage. Methods: This randomized prospective study included 30 feet from 23 patients aged between 7 and 17 years who underwent lateral calcaneal lengthening utilizing a PEEK cage to correct symptomatic flatfoot. Results: Calcaneal lengthening combined with reconstruction of the medial soft tissue led to notable correction in foot alignment. The lateral talometatarsal angle decreased from a preoperative mean of 26.25° to 3.37° at the final follow-up, while the AP-talonavicular angle improved from 31.07° preoperatively to 7.15°. The mean reductions in these angles were substantial, with a 27.83° decrease in the lateral talometatarsal angle and a 33.20° decrease in the talonavicular angle at the last follow-up. All PEEK cages achieved union with the calcaneus within an average of two months, with complete incorporation and remodeling occurring by six months. No complications were observed at the cage site, and there was no dorsal subluxation at the calcaneocuboid joint postoperatively. Two patients experienced recurrence of tendo-Achilles contracture, which was successfully managed with stretching exercises, without the need for further surgical intervention. Conclusions: The use of PEEK cages ensured reliable union and bone remodeling without complications, demonstrating the effectiveness of this procedure in treating flexible flatfoot with minimal risk of major adverse events. | ||
Keywords | ||
Calcaneal Lengthening; Flexible Flat Foot; PEEK Cage | ||
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