1. Case for small group discussion
Flatfoot deformity
Case for small group discussion
Double calcaneal osteotomy
AOTrauma—Foot & Ankle
Module 9: Acquired flatfoot deformity
Les Grujic, AU

2. Case description 55-year-old woman
Progressive painful flatfoot deformity

3. Preoperative x-rays

4. Postoperative x-rays
Double osteotomy with lateral column lengthening (LCL) and tuber slide

5. ZEVO tubercle osteotomy
Z-shaped elongation and varus osteotomy
Z-shaped osteotomy combining lateral column lengthening and medial shift of the calcaneal tuber
Excellent correction of two planes with good healing
Osteotomy developed by Per-Henrik Agren, Sweden

6. Take-home messages
Double calcaneal osteotomies (tubercle medial sliding and lateral column lengthening) may be used to correct valgus and abduction deformities
Nonarthritic and mobile hindfoot joints are a prerequisite for calcaneal osteotomies