Medial column procedures in the acquired flatfoot deformity

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Foot and Ankle Reconstruction

Background:

• Acquired flatfoot involves collapse of the medial foot column.
• Deformities often manifest as abduction and collapse at the talonavicular (TN), naviculocuneiform (NC), or tarsometatarsal (TMT) joints.
• Medial column procedures are crucial for correcting these deformities.

Purpose of the Study:

• To outline medial column procedures for acquired flatfoot treatment.
• To detail surgical techniques including arthrodesis and osteotomies.
• To define the indications for these procedures based on joint involvement.

Main Methods:

• Focus on arthrodesis of the TN, NC, and metatarsocuneiform (MTC) joints, individually or combined.
• Discussion of osteotomies of the cuneiforms.
• Consideration of procedures performed alone, with soft tissue reconstruction, or with lateral bony procedures.

Main Results:

• Medial column procedures effectively address deformities involving TN, NC, or TMT joint collapse.
• Arthrodesis and osteotomies provide reconstructive options for the medial foot column.
• Surgical outcomes depend on appropriate patient selection and procedural choice.

Conclusions:

• Medial column procedures are essential for correcting acquired flatfoot with specific joint involvement.
• A range of arthrodesis and osteotomy techniques are available for reconstruction.
• Careful consideration of the deformity's extent guides procedural selection for optimal correction.