The objective of this study was to investigate the modified Koutsogiannis medial slipped calcaneal osteotomy using clinical and radiographic parameters. From January 1997 through April 2001, twenty-nine feet of nineteen patients with idiopathic flexible pes planovalgus, whose mean age was 11.36 years, underwent the modified Koutsogiannis procedure to correct the slipped varus deformity, with an average follow-up period of sixteen months. Surgery was prescribed to patients presenting pain and fatigue symptoms, as well as any deformities. Clinically, seventeen patients reported absence of pain and sixteen did not present residual deformity, the correction of the deformity being noticed in the hind foot. In a 0-10 scale, the average value of the post-operative subjective results was of 9.36. Two poor results (pain and deformity resistance) were associated with ligamental hyperlaxity, with severe pre-operative deformity. Lateral view radiographs revealed a decrease in the pre-operative mean values of the talocalcaneal and talar-first metatarsal angles, from 29.7 and 11.33 degrees to 23.05 and 7.76 degrees, respectively, in the post-operative period. Anteroposterior view radiographs showed a decrease in the mean value of the talocalcaneal angle, from 36.39 to 35.42 degrees. The conclusion was that the Koutsogiannis procedure showed to be effective in the management of patients in the 1-13 year age group with mild to moderate idiopathic flexible pes planovalgus, presenting esthetic improvement, symptom relief and radiographic improvement.
Flatfoot; Surgery; Calcaneus; Osteotomy
