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Addressing Medial Column Instability in Flatfoot Deformity
Scott Schleunes1, Alan Catanzariti2
1Department of Orthopedics, Division of Foot & Ankle Surgery, West Penn Hospital, Pittsburgh, PA, USA.
Clinics in Podiatric Medicine and Surgery
|February 25, 2023
Summary
Maintaining a stable medial column is crucial for foot and ankle function. Medial column stabilization is recommended for forefoot varus, instability, or degenerative changes, often involving surgical fusion or osteotomy.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Biomechanics
Background:
- A stable medial column is essential for proper foot and ankle function.
- Medial column instability and forefoot varus can lead to compensatory hindfoot motion and medial soft-tissue stress.
Purpose of the Study:
- To outline indications for medial column stabilization.
- To review common surgical procedures for medial column stabilization.
Main Methods:
- Review of clinical indications for medial column stabilization.
- Description of surgical techniques including arthrodesis and osteotomy.
Main Results:
- Medial column stabilization is indicated in cases of forefoot varus post-hindfoot realignment.
- Stabilization is also considered for significant medial column instability without forefoot varus.
- Degenerative changes within medial column articulations are another indication for surgical intervention.
Conclusions:
- Medial column stabilization is a key consideration in specific foot and ankle pathologies.
- Surgical options include talonavicular, naviculocuneiform, and first tarsometatarsal joint arthrodesis, and Cotton osteotomy.
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