What is an Evans Osteotomy?
Evans osteotomy is a surgical procedure that involves lengthening the outer part of the heel bone (calcaneus) by inserting a bone graft to improve foot alignment and support. The procedure was named after Dr. Dillwyn Evans, who applied his deep understanding of the medial and lateral foot columns to treat calcaneovalgus in a patient with polio in 1961.
What is an Evans Osteotomy Used For?
Evans osteotomy is performed in both children and adults due to its low complication rate. It is primarily used to correct flexible flatfoot deformity, a condition which causes the arch of the foot to collapse during standing or walking. This deformity can cause the front of the foot to splay outward (abduction), leading to misalignment, discomfort, and impaired movement. Learn more about flatfoot deformity and treatment options.
About the Procedure
The procedure is typically performed under general anesthesia. Here’s what to expect:
- A small incision is made on the outer side of the foot.
- The surgeon cuts the calcaneus and gently opens a wedge in the front.
- A bone graft or implant is inserted to lengthen the bone.
- Often, hardware is used to secure the graft or implant. This might be a screw, a plate, or a pin.
- The incision is closed and the foot is immobilized.
In many cases, this procedure is combined with other soft tissue or bone procedures to address additional aspects of the flatfoot deformity.
Aftercare
Following surgery:
- Recovery can take 3 to 6 months depending on age, health, and whether other procedures were performed.
- The foot will be placed in a cast or boot for 6 to 8 weeks.
- You’ll need to avoid putting weight on the foot during early recovery.
- Physical therapy may be recommended to restore strength and range of motion.
FAQs
Flat feet can sometimes cause more than just changes in how your feet look. You might experience pain in your feet or ankles, especially after long periods of standing or walking. In some cases, the lack of proper arch support can affect your alignment and lead to discomfort in your knees, hips, or even your lower back. If left untreated over time, flat feet can also contribute to conditions like shin splints or early-onset arthritis.
Symptoms may include:
– Visible flattening of the arch
– Heel or arch pain
– Outward turning of the foot
– Fatigue in the feet or legs
– Trouble fitting into shoes
It’s a good idea to talk to a doctor if your foot pain starts interfering with your daily life or if you notice that the shape of your feet is changing over time. If supportive shoes or over-the-counter insoles no longer help, or if you’ve started having frequent ankle sprains or balance issues, it’s best to have your feet evaluated by a specialist.
Not everyone with flat feet needs surgery. An Evans osteotomy is usually recommended only when non-surgical options, such as custom orthotics, physical therapy, and lifestyle changes, haven’t provided enough relief. This procedure is typically reserved for people with flexible flatfoot who are still able to correct the shape of their foot manually, but are experiencing significant pain or difficulty with everyday activities.
Like any surgery, Evans osteotomy has risks, including:
– Infection
– Nonunion or delayed bone healing
– Overcorrection or undercorrection
– Continued or new foot pain
Most patients begin walking again in a boot or supportive shoe after 6 to 8 weeks. Full return to normal activities may take up to 3 to 6 months, depending on individual healing and physical therapy progress.
