To assess radiological and functional outcomes of modified extra-articular lateral column lengthening procedure for correction of adult acquired flexible flatfoot deformity

Measurement of

1. Calcencal pitch : This angle is formed on a weight-bearing lateral foot radiograph between the calcaneal Inclination axis and the supporting horizontal surface(10), normal ranges of between 10-25° and 20-30 have Been proposed(11)
2. Meary's angle: It is the angle between a line drawn along the longitudinal axis of the talus (mid-talar axis) and the first metatarsal (first metatarsal axis) , typically', Meary's angle is 0°, with abnormal values considered angle >4° convex upward: pes cavus , angle <-4 convex downward: pes planus, It can be used to classify the severity of deformity
3. lateral talocalceneal angle : the angle between the calcaneal inclination axis and the mid-talar axis , The lateral talocalcaneal angle should normally measure between 25 and 40°, >40° diagnoses flatfoot deformity(12)
4. Talonavicular coverage angle: it is the medial angle between ( talar head articular surface and Proximal navicular articular surface) ,Interpreting the talonavicular coverage angle (13)Normal: <7,Adult Acquired flatfoot disease: >7°

Inclusion Criteria:

- 1) Age : adult ( age above 16 years old and below 65 years old

2) symptomatic flexible flat foot after failure of Conservative treatment

Exclusion Criteria:

• 1- Age: (&amp;lt;16,&amp;gt;65) years old 2 -Previous foot surgery 3- autoimmune disease
• 4 Uncontrolled blood sugar 5- Osteoprotic patient 6- Infection

Adult flexible acquired flatfoot deformity which doesn&amp;#39;t include genetic or spasmodic flatfoot deformity in children