CME ArticleStepcut Calcaneal Lengthening Osteotomy in the Management of Stage IIB Adult-acquired Flatfoot Deformity: Surgical Technique and Review of LiteratureMetikala, Sreenivasulu MD*; Mahmoud, Karim MD*; Young, Kelsey MD†; Lee, Wonyong MD*; Wapner, Keith L. MD‡Author Information *Clinical Fellow – Orthopaedic Foot & Ankle Surgery, Department of Orthopaedic Surgery †Resident – Orthopaedic Surgery ‡Chief – Orthopaedic Foot & Ankle Surgery Service, Clinical Professor of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA Disclosure Statement: All authors, faculty, and staff, with the exception of Keith L. Wapner, in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity. Wapner reports a current relationship as a research consultant with Stryker, Wright Medical, and InnoMed. Lippincott CME Institute has identified and resolved all conflicts of interest concerning this educational activity. Address correspondence and reprint requests to Sreenivasulu Metikala, MD, Department of Orthopaedic Surgery, Division of Foot and Ankle Surgery, University of Pennsylvania Health System, 230 West Washington Square, 5th Floor, Philadelphia, PA 19106. E-mail: firstname.lastname@example.org. INSTRUCTIONS FOR OBTAININGAMA PRA CATEGORY 1 CREDITTM Techniques in Foot & Ankle Surgery includes CME-certiﬁed content that is designed to meet the educational needs of its readers. This activity is available for credit through May 31, 2022. Earn CME credit by completing a quiz about this article. You may read the article here, on the TFAS website, or in the TFAS iPad app, and then complete the quiz, answering at least 80 percent of the questions correctly to earn CME credit. The cost of the CME exam is $10. The payment covers processing and certiﬁcate fees. If you wish to submit the test by mail, send the completed quiz with a check or money order for the $10.00 processing fee to the Lippincott CME Institute, Inc., Wolters Kluwer Health, Two Commerce Square, 2001 Market Street, 3rd Floor, Philadelphia, PA 19103. Only the ﬁrst entry will be considered for credit, and must be postmarked by the expiration date. Answer sheets will be graded and certiﬁcates will be mailed to each participant within 6 to 8 weeks of participation. Need CME STAT? Visit http://cme.lww.com for immediate results, other CME activities, and your personalized CME planner tool. Accreditation Statement Lippincott Continuing Medical Education Institute, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit Designation Statement Lippincott Continuing Medical Education Institute, Inc., designates this journal-based CME activity for a maximum of 1 (one) AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Techniques in Foot & Ankle Surgery: June 2020 - Volume 19 - Issue 2 - p 114-121 doi: 10.1097/BTF.0000000000000278 Buy Take the CME Test Metrics Abstract The treatment principles in the surgical management of stage IIB adult-acquired flatfoot deformity include rebalancing of soft-tissues, correction of deformity and preservation of subtalar joint motion. Traditional medial displacement calcaneal osteotomy addresses hindfoot valgus but has no influence on forefoot abduction. The lateral calcaneal lengthening osteotomy can achieve satisfactory improvement of forefoot abduction and uncovering of the talonavicular but cannot efficiently manage hindfoot valgus when performed in isolation. We describe stepcut calcaneal lengthening osteotomy with a “Z” design, which is essentially a combination of the above techniques with an additional full-thickness transverse cut made along the long axis of calcaneus that has the ability to obtain deformity correction of forefoot and hindfoot through a single incision. Level of Evidence: Diagnostic Level V—Expert Opinion. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.