Article breakdown

Cole Osteotomy and Variations.

Clinics in podiatric medicine and surgery • 2026 Jan • Vol 43, 31-40. PMID 41266068.

This review says pes cavus, a high-arched foot shape, can be painful and disabling and may not improve with non-surgical treatment. It explains that surgery is often needed to create a pain-free, flat-on-the-ground foot, and that the Cole osteotomy is one option when the main deformity is in the middle of the foot. It reviews earlier medical knowledge rather than reporting one new experiment.

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In short

What this paper found

This review says pes cavus, a high-arched foot shape, can be painful and disabling and may not improve with non-surgical treatment.

It explains that surgery is often needed to create a pain-free, flat-on-the-ground foot, and that the Cole osteotomy is one option when the main deformity is in the middle of the foot.

It reviews earlier medical knowledge rather than reporting one new experiment.

Deep dive

What the paper is actually saying

Why This Paper Exists

Pes cavus can cause major symptoms and may not respond to non-surgical care, so clinicians need clear guidance on which surgical approaches may help.

What The Authors Wanted To Answer

The article looks at where the Cole osteotomy and related midfoot osteotomies fit in the treatment of symptomatic pes cavus, particularly when the main bend of the deformity is in the midfoot.

How The Study Was Done

This is a review article. From the abstract, it appears to review existing knowledge about pes cavus surgery and the use of midfoot osteotomies rather than report a single newly conducted study in one group of patients.

What The Study Found

The abstract says that choosing the right surgery depends on understanding the foot’s structure and the pattern of the deformity. It presents the Cole osteotomy as a useful way to reduce midfoot deformities, while also stating that midfoot osteotomies are almost never done by themselves and are usually part of a larger reconstruction plan.

Takeaway

For painful pes cavus that does not improve with non-surgical treatment, the Cole osteotomy is presented as an important surgical option when the deformity centers in the midfoot, but usually not as a stand-alone procedure.

Limits

What this abstract does not fully answer

Because this is a review, the abstract does not provide original patient data, sample size, or outcome numbers from one new study.

The abstract does not explain how the authors selected or evaluated the earlier literature, so it is unclear how systematic the review was.

The abstract does not report specific complication rates, comparative results, or long-term outcomes for the Cole osteotomy versus other procedures.

Key numbers

Numbers the abstract makes important

This abstract did not highlight a small set of decision-relevant numbers.

Source abstract

Original abstract sections

Abstract

Pes cavus can be a painful and debilitating condition that is often recalcitrant to conservative treatment. Oftentimes surgical reconstruction is necessary for the patient to obtain a pain-free plantigrade foot. An intimate knowledge of pes cavus foot architecture is necessary to select appropriate surgical treatment of the symptomatic patient. Midfoot osteotomies such as the Cole osteotomy can be a powerful procedure to reduce deformities where the apex is located in the midfoot. Midfoot osteotomies are almost never performed in isolation. Midfoot osteotomies including the Cole osteotomy are an attribute in any foot and ankle surgeon's armamentarium.