{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:43:02Z","timestamp":1788183782301,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"\n Background<\/jats:title>\n The Evans osteotomy is a widely used procedure for the correction of adult and pediatric flexible flatfoot deformity. Locking plates are commonly used to stabilize the osteotomy and the allograft. However, there have been incidences of soft-tissue irritation caused by the hardware, requiring subsequent hardware removal. Therefore, we sought to review whether age, sex, or laterality of the procedure had any correlation with the rate of hardware removal.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective review was performed of 47 consecutive patients who underwent an Evans calcaneal osteotomy between October 1, 2013, and October 1, 2016. Data were collected and analyzed based on age, sex, laterality, and the need for hardware removal.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All of the 47 patients met the inclusion criteria. Seventy procedures were performed, and hardware removal was required in 16 patients and 21 feet (30%). The only statistically significant finding was that 11 females and only five males required either unilateral or bilateral hardware removal (\n P<\/jats:italic>\n = .039). All 16 patients reported complete pain relief after hardware removal.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Females are twice as likely as males to develop symptoms after locking plate application over an Evans osteotomy and may require hardware removal. Despite the low-profile nature of the locking plate to fixate the Evans osteotomy, the hardware can be a source of significant pain. Patients, especially females, should be cautioned about potential hardware-related pain and a possible follow-up procedure to remove the hardware.<\/jats:p>\n <\/jats:sec>","DOI":"10.7547\/17-096","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T01:54:04Z","timestamp":1591322044000},"source":"Crossref","is-referenced-by-count":5,"title":["Procedure-Specific Hardware Removal After Evans Osteotomy"],"prefix":"10.3390","volume":"110","author":[{"given":"Patrick A.","family":"DeHeer","sequence":"first","affiliation":[{"name":"Department of Podiatric Surgery, St. Vincent's Hospital, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrunjay","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Podiatric Surgery, St. Vincent's Hospital, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah N.","family":"Standish","sequence":"additional","affiliation":[{"name":"Department of Podiatric Surgery, St. Vincent's Hospital, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"i8750-7315-110-2-Article_1-b01","series-title":"J Bone Joint Surg Br","first-page":"270","article-title":"Calcaneo-valgus deformity","volume":"57","author":"Evans","year":"1975","unstructured":"Evans\n D:\n \n \n Calcaneo-valgus deformity.\n\t\t\t\t\tJ Bone Joint Surg Br57: \n\t\t\t\t\t270,\n\t\t\t\t\t1975.\n\t\t\t\t1171869"},{"key":"i8750-7315-110-2-Article_1-b02","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1053\/j.jfas.2015.03.013","article-title":"Mid-calcaneal length after Evans calcaneal osteotomy: a retrospective comparison of wedge locking plates and tricortical allograft wedges","volume":"54","author":"Protzman","year":"2015","unstructured":"Protzman\n NM\n \n \n Wobst\n GM\n \n \n Storts\n EC\n \n :\n\t\t\t\t\t\n Mid-calcaneal length after Evans calcaneal osteotomy: a retrospective comparison of wedge locking plates and tricortical allograft wedges.\n\t\t\t\t\tJ Foot Ankle Surg54: \n\t\t\t\t\t900,\n\t\t\t\t\t2015.\n\t\t\t\t2599847010.1053\/j.jfas.2015.03.013http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000360373600027&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_1-b03","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1053\/j.jfas.2011.04.004","article-title":"Displacement of the anterior process of the calcaneus after Evans calcaneal osteotomy","volume":"50","author":"Dunn","year":"2011","unstructured":"Dunn\n SP\n \n \n Meyer\n J:\n \n \n Displacement of the anterior process of the calcaneus after Evans calcaneal osteotomy.\n\t\t\t\t\tJ Foot Ankle Surg50: \n\t\t\t\t\t402,\n\t\t\t\t\t2011.\n\t\t\t\t10.1053\/j.jfas.2011.04.00421708341http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000292036100008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_1-b04","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1053\/j.jfas.2012.01.003","article-title":"Incidence of nonunion of the unfixated, isolated Evans calcaneal osteotomy: a systematic review","volume":"51","author":"Prissel","year":"2012","unstructured":"Prissel\n MA\n \n \n Roukis\n TS:\n \n \n Incidence of nonunion of the unfixated, isolated Evans calcaneal osteotomy: a systematic review.\n\t\t\t\t\tJ Foot Ankle Surg51: \n\t\t\t\t\t323,\n\t\t\t\t\t2012.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000303106200012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1053\/j.jfas.2012.01.00322300686"},{"key":"i8750-7315-110-2-Article_1-b05","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1053\/j.jfas.2013.05.002","article-title":"Effectiveness of a locking plate in preserving midcalcaneal length and positional outcome after Evans calcaneal osteotomy: a retrospective pilot study","volume":"52","author":"Dayton","year":"2013","unstructured":"Dayton\n P\n \n \n Prins\n DB\n \n \n Smith\n DE\n \n :\n\t\t\t\t\t\n Effectiveness of a locking plate in preserving midcalcaneal length and positional outcome after Evans calcaneal osteotomy: a retrospective pilot study.\n\t\t\t\t\tJ Foot Ankle Surg52: \n\t\t\t\t\t710,\n\t\t\t\t\t2013.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000326908700004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f32380057410.1053\/j.jfas.2013.05.002"},{"key":"i8750-7315-110-2-Article_1-b06","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1177\/1071100712473742","article-title":"Comparison of three different fixation methods of calcaneal osteotomies","volume":"34","author":"Abbasian","year":"2013","unstructured":"Abbasian\n A\n \n \n Zaidi\n R\n \n \n Guha\n A\n \n :\n\t\t\t\t\t\n Comparison of three different fixation methods of calcaneal osteotomies.\n\t\t\t\t\tFoot Ankle Int34: \n\t\t\t\t\t420,\n\t\t\t\t\t2013.\n\t\t\t\t23391624http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000330307400017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1177\/1071100712473742"},{"key":"i8750-7315-110-2-Article_1-b07","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1053\/j.jfas.2011.05.011","article-title":"Double calcaneal osteotomy using single, dual function screw fixation technique","volume":"50","author":"DiDomenico","year":"2011","unstructured":"DiDomenico\n LA\n \n \n Haro\n AA\n \n \n Cross\n DJ:\n \n \n Double calcaneal osteotomy using single, dual function screw fixation technique.\n\t\t\t\t\tJ Foot Ankle Surg50: \n\t\t\t\t\t773,\n\t\t\t\t\t2011.\n\t\t\t\t10.1053\/j.jfas.2011.05.011http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000296538900032&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f321737314"},{"key":"i8750-7315-110-2-Article_1-b08","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1053\/j.jfas.2014.04.017","article-title":"Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation","volume":"54","author":"Boffeli","year":"2015","unstructured":"Boffeli\n TJ\n \n \n Abben\n KW:\n \n \n Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation.\n\t\t\t\t\tJ Foot Ankle Surg54: \n\t\t\t\t\t478,\n\t\t\t\t\t2015.\n\t\t\t\t10.1053\/j.jfas.2014.04.01724856664http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000353349900039&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_1-b09","series-title":"Foot Ankle Spec","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1177\/1938640009338391","article-title":"Double-calcaneal osteotomy with a unilateral rail external fixator for correction of pes planus","volume":"2","author":"Penney","year":"2009","unstructured":"Penney\n NT\n \n \n Viselli\n SJ\n \n \n Holmes\n TR\n \n :\n\t\t\t\t\t\n Double-calcaneal osteotomy with a unilateral rail external fixator for correction of pes planus.\n\t\t\t\t\tFoot Ankle Spec2: \n\t\t\t\t\t194,\n\t\t\t\t\t2009.\n\t\t\t\t10.1177\/193864000933839119825774"},{"key":"i8750-7315-110-2-Article_1-b10","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/S1067-2516(01)80042-9","article-title":"The Evans osteotomy: technique and fixation with cortical bone pin","volume":"40","author":"Weinraub","year":"2001","unstructured":"Weinraub\n GM\n \n \n Daulat\n R:\n \n \n The Evans osteotomy: technique and fixation with cortical bone pin.\n\t\t\t\t\tJ Foot Ankle Surg40: \n\t\t\t\t\t54,\n\t\t\t\t\t2001.\n\t\t\t\t10.1016\/S1067-2516(01)80042-911202769"},{"key":"i8750-7315-110-2-Article_1-b11","series-title":"Foot Ankle Int","first-page":"400","article-title":"Contribution of lateral column lengthening to correction of forefoot abduction in stage IIb adult acquired flatfoot deformity reconstruction","volume":"36","author":"Chan","year":"2015","unstructured":"Chan\n JY\n \n \n Greenfield\n ST\n \n \n Soukup\n DS\n \n :\n\t\t\t\t\t\n Contribution of lateral column lengthening to correction of forefoot abduction in stage IIb adult acquired flatfoot deformity reconstruction.\n\t\t\t\t\tFoot Ankle Int36: \n\t\t\t\t\t400,\n\t\t\t\t\t2015.\n\t\t\t\thttp:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000367841700002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_1-b12","series-title":"Foot Ankle Clin","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/S1083-7515(03)00083-4","article-title":"Operative treatment of the difficult stage 2 adult acquired flatfoot deformity","volume":"6","author":"Mosier-Laclair","year":"2001","unstructured":"Mosier-Laclair\n S\n \n \n Pomeroy\n G\n \n \n Manoli\n A:\n \n \n Operative treatment of the difficult stage 2 adult acquired flatfoot deformity.\n\t\t\t\t\tFoot Ankle Clin6: \n\t\t\t\t\t95,\n\t\t\t\t\t2001.\n\t\t\t\t10.1016\/S1083-7515(03)00083-411385931"},{"key":"i8750-7315-110-2-Article_1-b13","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1177\/107110079701800404","article-title":"A new operative approach for flatfoot secondary to posterior tibial tendon insufficiency: a preliminary report","volume":"18","author":"Pomeroy","year":"1997","unstructured":"Pomeroy\n GC\n \n \n Manoli\n A:\n \n \n A new operative approach for flatfoot secondary to posterior tibial tendon insufficiency: a preliminary report.\n\t\t\t\t\tFoot Ankle Int18: \n\t\t\t\t\t206,\n\t\t\t\t\t1997.\n\t\t\t\t912710910.1177\/107110079701800404"},{"key":"i8750-7315-110-2-Article_1-b14","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1177\/107110079801901106","article-title":"Evans osteotomy in the adult foot: an anatomic study of structures at risk","volume":"19","author":"Raines","year":"1998","unstructured":"Raines\n RA\n Jr,\n \n \n Brage\n ME:\n \n \n Evans osteotomy in the adult foot: an anatomic study of structures at risk.\n\t\t\t\t\tFoot Ankle Int19: \n\t\t\t\t\t743,\n\t\t\t\t\t1998.\n\t\t\t\t984020210.1177\/107110079801901106"},{"key":"i8750-7315-110-2-Article_1-b15","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1177\/1071100712473742","article-title":"Comparison of three different fixation methods of calcaneal osteotomies","volume":"34","author":"Abbasian","year":"2013","unstructured":"Abbasian\n A\n \n \n Zaidi\n R\n \n \n Guha\n A\n \n :\n\t\t\t\t\t\n Comparison of three different fixation methods of calcaneal osteotomies.\n\t\t\t\t\tFoot Ankle Int34: \n\t\t\t\t\t420,\n\t\t\t\t\t2013.\n\t\t\t\t23391624http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000330307400017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1177\/1071100712473742"},{"key":"i8750-7315-110-2-Article_1-b16","series-title":"J Foot Ankle Surg","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1053\/j.jfas.2010.04.023","article-title":"Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis","volume":"49","author":"Haeseker","year":"2010","unstructured":"Haeseker\n GA\n \n \n Mureau\n MA\n \n \n Faber\n FWM\n \n :\n\t\t\t\t\tLateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis.\n\t\t\t\t\tJ Foot Ankle Surg49: \n\t\t\t\t\t380,\n\t\t\t\t\t2010.\n\t\t\t\t10.1053\/j.jfas.2010.04.02320610204http:\/\/gateway.webofknowledge.com\/gateway\/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000279330900013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3"},{"key":"i8750-7315-110-2-Article_1-b17","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1177\/107110070102201102","article-title":"Morbidity associated with ORIF of intra-articular calcaneus fractures using a lateral approach","volume":"22","author":"Harvey","year":"2001","unstructured":"Harvey\n EJ\n \n \n Grujic\n L\n \n \n Early\n JS\n \n :\n\t\t\t\t\t\n Morbidity associated with ORIF of intra-articular calcaneus fractures using a lateral approach.\n\t\t\t\t\tFoot Ankle Int22: \n\t\t\t\t\t868,\n\t\t\t\t\t2001.\n\t\t\t\t10.1177\/10711007010220110211722137"},{"key":"i8750-7315-110-2-Article_1-b18","article-title":"Are foot and ankle problems worse for women?","author":"Baumhauer","unstructured":"Baumhauer\n JF\n \n \n O'Connor\n K:\n \n \n Are foot and ankle problems worse for women?\n Available at: http:\/\/www.aaos.org\/news\/aaosnow\/mar08\/clinical2.asp.\n [Member-only document]."},{"key":"i8750-7315-110-2-Article_1-b19","series-title":"Med Sci Sports Exerc","first-page":"605","article-title":"Gender differences in adult foot shape: implications for shoe design","volume":"33","author":"Wunderlich","year":"2001","unstructured":"Wunderlich\n RE\n \n \n Cavanagh\n PR:\n \n \n Gender differences in adult foot shape: implications for shoe design.\n\t\t\t\t\tMed Sci Sports Exerc33: \n\t\t\t\t\t605,\n\t\t\t\t\t2001.\n\t\t\t\t11283437"},{"key":"i8750-7315-110-2-Article_1-b20","series-title":"J Musculoskelet Med","first-page":"35","article-title":"Shoes designed specifically for women's feet usually fit best: helping the athletic woman find a shoe that fits","volume":"15","author":"Frey","year":"1998","unstructured":"Frey\n C:\n \n \n Shoes designed specifically for women's feet usually fit best: helping the athletic woman find a shoe that fits.\n\t\t\t\t\tJ Musculoskelet Med15: \n\t\t\t\t\t35,\n\t\t\t\t\t1998."},{"key":"i8750-7315-110-2-Article_1-b21","series-title":"McGlamry's Comprehensive Textbook of Foot and Ankle Surgery,","article-title":"\u201cPosterior Tibial Tendon Dysfunction,\u201d","author":"Catanzariti","year":"2012","unstructured":"Catanzariti\n AR\n \n \n Mendicino\n RW\n \n \n Maskill\n RP:\n \n \n \u201cPosterior Tibial Tendon Dysfunction,\u201d\n in Southerland JT, Downey MS, Boberg JS, et al, eds:\n \n McGlamry's Comprehensive Textbook of Foot and Ankle Surgery,\n \n 4th Ed, p 640, Lippincott Williams & Wilkins, Philadelphia,\n September\n 2012."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/110\/2\/i8750-7315-110-2-article_1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/japma\/article-pdf\/doi\/10.7547\/17-096\/2494296\/i8750-7315-110-2-article_1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/110\/2\/i8750-7315-110-2-article_1.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/110\/2\/i8750-7315-110-2-article_1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:17:50Z","timestamp":1783505870000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/110\/2\/17096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,1]]},"references-count":21,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/17-096","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2020,3,1]]}}}