Summary:Isolated flexor digitorum longus tendon transfers for reconstruction of stage II posterior tibial tendon insufficiency have limited effect on restoring the longitudinal arch. Use of ancillary os calcis osteotomies has recently gained popularity for both maintaining a weightbearing arch and for improving survivorship of soft tissue tendon procedures. A modification of the Evan's lateral column lengthening procedure, which consists of distraction arthrodesis of the calcaneocuboid joint, can restore the geometry of the foot while preserving hindfoot mobility.