Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation

Abstract Objective Flexible flat foot deformity refers to a deformity where there is a decrease in or absence of the medial longitudinal arch of the foot upon weight-bearing along with hindfoot valgus, midfoot abduction and forefoot varus. Evan’s calcaneal osteotomy is a standard procedure used glob...

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Main Authors: Mohamad Samih Yasin, Hashim A. Rayyan, Mira Khaldoun Eid, Nour Ahmad Awamleh, Sara Osama Rahhal, Rama Rawashdeh, Ahmad A. Toubasi, Mahmoud S. Alqawasmi, Omar Q. Samarah, Bassem I. Haddad, Aws Khanfar
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08978-1
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author Mohamad Samih Yasin
Hashim A. Rayyan
Mira Khaldoun Eid
Nour Ahmad Awamleh
Sara Osama Rahhal
Rama Rawashdeh
Ahmad A. Toubasi
Mahmoud S. Alqawasmi
Omar Q. Samarah
Bassem I. Haddad
Aws Khanfar
author_facet Mohamad Samih Yasin
Hashim A. Rayyan
Mira Khaldoun Eid
Nour Ahmad Awamleh
Sara Osama Rahhal
Rama Rawashdeh
Ahmad A. Toubasi
Mahmoud S. Alqawasmi
Omar Q. Samarah
Bassem I. Haddad
Aws Khanfar
author_sort Mohamad Samih Yasin
collection DOAJ
description Abstract Objective Flexible flat foot deformity refers to a deformity where there is a decrease in or absence of the medial longitudinal arch of the foot upon weight-bearing along with hindfoot valgus, midfoot abduction and forefoot varus. Evan’s calcaneal osteotomy is a standard procedure used globally to correct deformities when clinically indicated, but its qualitative clinical and radiological outcomes have rarely been discussed. This study aimed to examine patients’ quality of life and radiological improvement after Evan’s osteotomy. Methods Data were obtained retrospectively from the orthopedic database of Jordan University Hospital, including a total of 27 patients between the ages of 8 and 23 years who underwent Evan’s calcaneal osteotomy for flexible flatfoot deformity within the specified period (2017–2021). Eight radiological parameters were used to assess and compare X-rays, while the foot health status questionnaire (FHSQ) was used to compare their preoperative and 6-month postoperative characteristics. Results Postoperative clinical outcomes revealed that footwear scores (p = 0.002), general foot health (MD = 2.46 ± 0.72, p = 0.001), and FSHQ scores were significantly greater (MD = 2.54 ± 0.59, p = 0.001) than preoperative scores were. In addition, the postoperative talocalcaneal angle values, calcaneo-cuboid angle (CCA), talo-1st metatarsal angle, talar declination angle (TDA) and Meary’s angle were significantly lower than the preoperative values. However, talar head coverage (MD=-10.23% ± 6.80%, p < 0.001) and the calcaneal inclination angle (CIA) (MD=-9.89 ± 6.47, p < 0.001) were significantly greater postoperatively than preoperatively. Conclusion Significant clinical and radiological improvement were achieved with Evan’s osteotomy. This is very important for providing physicians with concrete qualitative data when surgery is indicated for symptomatic patients and highlights the importance of performing a meticulous surgical technique addressing all aspects of the pathology for a better outcome.
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spelling doaj-art-4ce6c069109e4c2c874da22053594cce2025-08-20T04:01:47ZengBMCBMC Musculoskeletal Disorders1471-24742025-08-0126111210.1186/s12891-025-08978-1Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigationMohamad Samih Yasin0Hashim A. Rayyan1Mira Khaldoun Eid2Nour Ahmad Awamleh3Sara Osama Rahhal4Rama Rawashdeh5Ahmad A. Toubasi6Mahmoud S. Alqawasmi7Omar Q. Samarah8Bassem I. Haddad9Aws Khanfar10Division of Orthopedics, Department of Special Surgery, School of Medicine, The University of JordanSchool of Medicine, The University of JordanJordanian Royal Medical ServicesSchool of Medicine, The University of JordanSchool of Medicine, The University of JordanSchool of Medicine, The University of JordanSchool of Medicine, The University of JordanDivision of Orthopedics, Department of Special Surgery, School of Medicine, The University of JordanDivision of Orthopedics, Department of Special Surgery, School of Medicine, The University of JordanDivision of Orthopedics, Department of Special Surgery, School of Medicine, The University of JordanDivision of Orthopedics, Department of Special Surgery, School of Medicine, The University of JordanAbstract Objective Flexible flat foot deformity refers to a deformity where there is a decrease in or absence of the medial longitudinal arch of the foot upon weight-bearing along with hindfoot valgus, midfoot abduction and forefoot varus. Evan’s calcaneal osteotomy is a standard procedure used globally to correct deformities when clinically indicated, but its qualitative clinical and radiological outcomes have rarely been discussed. This study aimed to examine patients’ quality of life and radiological improvement after Evan’s osteotomy. Methods Data were obtained retrospectively from the orthopedic database of Jordan University Hospital, including a total of 27 patients between the ages of 8 and 23 years who underwent Evan’s calcaneal osteotomy for flexible flatfoot deformity within the specified period (2017–2021). Eight radiological parameters were used to assess and compare X-rays, while the foot health status questionnaire (FHSQ) was used to compare their preoperative and 6-month postoperative characteristics. Results Postoperative clinical outcomes revealed that footwear scores (p = 0.002), general foot health (MD = 2.46 ± 0.72, p = 0.001), and FSHQ scores were significantly greater (MD = 2.54 ± 0.59, p = 0.001) than preoperative scores were. In addition, the postoperative talocalcaneal angle values, calcaneo-cuboid angle (CCA), talo-1st metatarsal angle, talar declination angle (TDA) and Meary’s angle were significantly lower than the preoperative values. However, talar head coverage (MD=-10.23% ± 6.80%, p < 0.001) and the calcaneal inclination angle (CIA) (MD=-9.89 ± 6.47, p < 0.001) were significantly greater postoperatively than preoperatively. Conclusion Significant clinical and radiological improvement were achieved with Evan’s osteotomy. This is very important for providing physicians with concrete qualitative data when surgery is indicated for symptomatic patients and highlights the importance of performing a meticulous surgical technique addressing all aspects of the pathology for a better outcome.https://doi.org/10.1186/s12891-025-08978-1FlatfootFlexibleEvansDeformityAdolescent
spellingShingle Mohamad Samih Yasin
Hashim A. Rayyan
Mira Khaldoun Eid
Nour Ahmad Awamleh
Sara Osama Rahhal
Rama Rawashdeh
Ahmad A. Toubasi
Mahmoud S. Alqawasmi
Omar Q. Samarah
Bassem I. Haddad
Aws Khanfar
Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
BMC Musculoskeletal Disorders
Flatfoot
Flexible
Evans
Deformity
Adolescent
title Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
title_full Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
title_fullStr Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
title_full_unstemmed Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
title_short Clinical and radiological outcomes of Evan’s osteotomy in young patients with flexible flatfoot deformity: a retrospective investigation
title_sort clinical and radiological outcomes of evan s osteotomy in young patients with flexible flatfoot deformity a retrospective investigation
topic Flatfoot
Flexible
Evans
Deformity
Adolescent
url https://doi.org/10.1186/s12891-025-08978-1
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