Anatomy of the Flat Foot

The purpose of this paper is to advocate simple calcaneal osteotomy as an effective treatment to relieve fatigue, improve shape and prevent abnormal shoe wear in patients with mobile flat foot. It is reserved for those cases in which conservative measures have failed and the symptoms warrant surgical treatment. The concept of calcaneal osteotomy is an old one. The first description was given by Gleich iii 1893 (quoted by Silver, Simon, Spindell, Litchman and Scala 1967). Gleich’s technique involved displacement of the posterior fragment forwards, medially and downwards in an attempt to restore the normal angle between the long axis of the calcaneus and the floor. This was achieved by excision of a medial wedge. In 1923 Lord reported thirteen cases of calcaneal osteotomy for severe flat foot. Only one patient, however, had calcaneal osteotomy alone; the others all required supplementary procedures. Dwyer (1960) advocated calcaneal osteotomy with insertion of a tibial graft in the outer side. He believed that the basic principles were the same whether the patient suffered from