Purpose or Case Report: Pes planus, commonly associated with hindfoot valgus, is a common condition in the adolescent population. Radiologists are generally familiar with the biometric measurements of calcaneal pitch and talocalcaneal angles. However, we are not so savvy in our interpretation of the many operative procedures employed by podiatrists and orthopedic surgeons to correct the planovalgus foot.
Preferred surgical techniques may vary by profession and institution with a variety of at least five different procedures used by surgeons to improve hindfoot/midfoot alignment, some of which may not be visible radiographically. Commonly encountered post-operative procedures include the calcaneal osteotomy (wedge or shift); medial cuneiform osteotomy; and arthroereisis at the sinus tarsi. While there can be a variety of implant screws and devices for each procedure, or none at all, each can be recognized radiographically with the intended result of improved plantar arch and hindfoot alignment. Unless there has been resection of an accessory navicular ossification, the tendon advancement and tenodesis procedures would often be radiographically occult.
The purpose of this educational exhibit is to demystify the intention of the many surgical approaches to correct the planovalgus foot. After this review, our audience should be able to appreciate the pre-surgical indications and post-operative intentions of hindfoot alignment to better report these findings and potential complications.
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