Introduction: There is considerable debate as to the ideal
procedure for the treatment of symptomatic flexible flatfoot
(FFF) that is not followed by recurrence and minimizes
complications. The purpose of the present study was to evaluate
the results of calcaneal lengthening using Mosca's technique in
adolescents with FFF in whom conservative treatment had been
applied for more than one year but had failed.
Patients and Methods: Calcaneal lengthening osteotomy was
performed using Mosca's technique in 19 feet of 14 patients
with ten males, four females and five bilateral cases. The mean
age at surgery was 13.53 (range 11.5-16) years. All FFF
patients were evaluated as idiopathic. Bilateral cases were
operated on at two sessions with an average interval of 15.6
months (range 12 to 21). The American Orthopaedic Foot and
Ankle Society (AOFAS) ankle-hind foot scale was used for
clinical assessment, and radiographic assessment was based on
six parameters on standard anteroposterior and lateral
radiographs.
Results: The mean follow-up period was 27.89 (range 18-44)
months. The mean AOFAS score increased from 57.53
preoperatively to 96.32 postoperatively. All radiographic
parameters significantly improved. Four patients had mild
occasional pain. There was no nonunion or secondary
subsidence of the arch. All Patients stated they were satisfied
with the procedure.
Conclusion: Correction of flexible flatfoot deformity with
Mosca's lateral calcaneal lengthening was an effective and
reproducible method to restore normal foot alignment and good
function.