Current Concepts In Surgery For Adult-Acquired Flatfoot
DiDomenico and colleagues performed a retrospective study of 34 patients with stage II AAF who had surgery without a flexor digitorum longus transfer.39 They noted statistically significant changes in structural realignment and concluded that surgeons can avoid flexor digitorum longus transfer without compromising the outcome when surgically treating stage II AAF. Therefore, we focus primarily on osseous reconstruction to address stage II AAF and secondarily on soft tissue reconstruction.
Surgical management of stage II adult-acquired flatfoot is important in preventing progression of the deformity, adaptation of the osseous and soft tissue structures, end-stage arthritis and ankle malalignment. The surgical approach and procedure selection should be based on the pathology one encounters at any given time. Surgeons should be familiar with a set of procedures that address all pathological components of stage II AAF.
Dr. Catanzariti is the Director of Residency Training and the Chair of the Division of Foot and Ankle Surgery at the Western Pennsylvania Hospital in Pittsburgh. He is a Fellow of the American College of Foot and Ankle Surgeons.
Dr. Mendicino is a Foot and Ankle Surgeon at Pinnacle Orthopedics Associates in Salisbury, N.C. He is a Fellow and Past President of the American College of Foot and Ankle Surgeons.
Dr. Hentges is a second-year foot and ankle surgery resident in the Division of Foot and Ankle Surgery at the Western Pennsylvania Hospital in Pittsburgh.