TABLE 1.

Tips and pitfalls of midfoot osteotomy combined with Ilizarov distraction.

Tips	Pitfalls
Perform the procedures of soft tissue release before bony correction.	The bony deformity needs to be re‐evaluated and correction plan may be intraoperatively adjusted after soft tissue release. Otherwise, overcorrection may occur.
Midfoot osteotomy should be carefully performed at the apex of deformity under the fluoroscopy according to the correction plan.	During the surgery, preoperative planning should be implemented as much as possible during the operation, and there should be no illusion of resolving residual deformities through postoperative distraction.
Tendon transfer procedures are individualized based on preoperative physical examination.	Tendon transfer surgery can only solve the problem of muscle imbalance. Patients with serious dysregulation of the neuromuscular system (e.g., severe spasmatic cerebral palsy) are usually predicted to have poor clinical outcomes.Surgical correction of pes cavus deformity could only be performed for these patients with great caution when their neuromuscular symptoms could be improved by additional management.
Intraoperative confirmation of complete osteotomy should be made, and postoperative distraction should be performed promptly.The distraction speed should be controlled between 0.5 and 1 mm per day.	Failure to perform a complete osteotomy, a longer latency period and a slow distraction rate could result in premature consolidation in the distraction gap which needs to be solved by a secondary surgery. But excessive distraction speed can lead to soft tissue injury or neurovascular complications.
The toes should be fixed by 1.0 mm K‐wires to avoid the complication of subluxated toe joints.	The importance of postoperative rehabilitation needs to be emphasized, otherwise it will lead to stiff toes.