Non-neuropathic midfoot multiplanar deformity: surgical strategies for reconstruction

The most common multiplanar deformity of the midfoot is pes planovalgus. Clinically, the flatfoot is characterized by a depressed or absent medial longitudinal arch accompanied by forefoot abduction and, in some cases, by supination of the forefoot and valgus angulation of the hindfoot. This article reviews the reconstructive strategies for correction of deformity and fusion of the painful arthritic joints. A stepwise surgical approach is recommended for reproducible correction and midfoot fusion in patients with arthritis combined with a multiplanar deformity. The article focuses on the principles of reconstruction of the planovalgus deformity in the non-neuropathic patient using compression plates for a stable construct fixation.