Where are the landmarks for Evan's osteotomy located?

Where are the landmarks for Evan's osteotomy located?

• A. Base of the fifth metatarsal
• B. Junction of the anterior superior calcaneus and the floor of the sinus tarsi
• C. Tip of the medial malleolus
• D. Dorsal aspect of calcaneal tuberosity

Answer: (B)

Evan's osteotomy is a lateral column lengthening procedure in the calcaneus used to correct flexible flatfoot by lengthening the outer column of the hindfoot. The surgical landmarks are located at the junction of the anterior superior aspect of the calcaneus and the floor of the sinus tarsi. This spot places the osteotomy in the correct region of the calcaneus—just anterior to the subtalar joint—so a wedge graft can be inserted to lengthen the lateral column without disrupting the subtalar articulation or important tendons. Using the sinus tarsi floor as a guide provides a reliable and reproducible reference for the osteotomy plane. Other sites listed don’t correspond to the proper calcaneal locus for this procedure: those points pertain to other parts of the foot or ankle and would not allow the desired lateral column lengthening without introducing other risks.

Evan's osteotomy is a lateral column lengthening procedure in the calcaneus used to correct flexible flatfoot by lengthening the outer column of the hindfoot. The surgical landmarks are located at the junction of the anterior superior aspect of the calcaneus and the floor of the sinus tarsi. This spot places the osteotomy in the correct region of the calcaneus—just anterior to the subtalar joint—so a wedge graft can be inserted to lengthen the lateral column without disrupting the subtalar articulation or important tendons. Using the sinus tarsi floor as a guide provides a reliable and reproducible reference for the osteotomy plane. Other sites listed don’t correspond to the proper calcaneal locus for this procedure: those points pertain to other parts of the foot or ankle and would not allow the desired lateral column lengthening without introducing other risks.