What procedure will improve the midtarsal locking mechanism?

What procedure will improve the midtarsal locking mechanism?

• A. Evan's calcaneal osteotomy
• B. Dwyer osteotomy
• C. Cotton osteotomy
• D. Lapidus procedure

Answer: (A)

Midtarsal locking depends on having a stable hindfoot alignment that brings the talonavicular and calcaneocuboid joints into a congruent, rigid position during stance. When the hindfoot is overly valgus or unstable, the midtarsal joints stay unlocked and the arch collapses, reducing propulsion efficiency. The procedure that most effectively restores hindfoot alignment and promotes that locked configuration is Evan’s calcaneal osteotomy. By altering the hindfoot alignment through a lateral column procedure, it improves the subtalar mechanics and midtarsal joint congruence, boosting the locked foot position during push-off. The other procedures target different aspects of foot structure (forefoot alignment, medial column height, or first-ray stability) and do not address the midtarsal locking mechanism as directly.