The surgical treatment of valgus flat foot in the adolescent by osteotomy of calcaneum associated with tenodesis of tibialis anterior and posterior.

In the treatment of valgus flat foot in adolescent patients, when growth has nearly ceased (about 13 years in the female and 15 in the male) the operation of choice is varus osteotomy of the calcaneum, stabilised by a homoplastic bone wedge, together with tenodesis of tibialis anterior and posterior. At this age, skeletal growth is not sufficient to guarantee corrective evolution of the deformity after repositioning of the calcaneo-talar joint by any surgical technique. Varising osteotomy of the calcaneum offers the advantage of avoiding sacrifice of the calcaneo-talar joint, as in the Grice-Green arthrodesis, which although indicated for the paralytic valgus flat foot, is not appropriate in the idiopathic variety.

Pes cavus: treatment by naviculo-cuboid osteotomy.

The treatment of pes cavus in the adult by the V osteotomy of Japas has several advantages if performed before the onset of secondary arthritic degeneration. The correction is carried out at the apex of the cavus and is technically simple. Consolidation is rapid, and correction is achieved with no significant sacrifice of movement.

The surgical treatment of mobile valgus flat foot in children.

The indications for surgical intervention in the treatment of mobile valgus flat foot in children are based on the age of the patient and the severity of the lesion. This depends on an accurate pre-operative assessment based on many clinical and radiographic signs and is the only way of deciding when orthotic treatment and physiokinesotherapy should be replaced by surgery.