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A 67-year-old patient presents with a several year history of chronic right medial ankle pain that has failed conservative treatment. Despite the use of orthotics and Arizona bracing, the patient's foot has become flatter over time. There is tenderness along the joint line and pain with passive dorsiflexion and plantarflexion of the tibiotalar joint. Weakness and pain are appreciated with resisted foot inversion. The patient has a rigid hindfoot and is unable to perform a single heel raise. Figures A, B, and C are current radiographs. What is the most appropriate treatment?
Medial slide calcaneal osteotomy, FDL transfer to the navicular, lateral column lengthening, cotton osteotomy, calcaneonavicular ligament reconstruction with peroneus longus tendon, deltoid ligament reconstruction
Total ankle arthroplasty
Triple arthrodesis with deltoid ligament reconstruction
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