[Reconstructive surgery of malunited joint fractures of the foot]

Innovative diagnostic methods such as the CT scan, MRI and 3rd-dimensional models of the foot and free-flap surgery to improve the soft tissues in the foot have all introduced new dimensions in reconstructive foot surgery. Of the foot bones only intra-articular fractures of the astragalus should be corrected because of its key position and the involvement of three joints. In double and triple arthrodesis, the axes and lengths of the medial and lateral columns should be corrected to prevent arthritis at the higher or lower joint level. Pan-talar arthrodesis can be worse than a well-done amputation below the knee. Cannulated 6.5 cancellous screws in double and triple arthrodesis and 3.5 corticalis screws in Lisfranc fusions allow stable fixation and function early after treatment.