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An active 70-year-old female presents to your office with increasing foot pain over the last several years. She enjoys walking however is limited to 2 blocks due to pain. Her pain is greatest with "push off". She has attempted shoe wear modifications, orthotics, physical therapy and non steroidal anti-inflammatories with limited relief of her symptoms. Her current weight bearing radiographs are seen in Figures A, B and C. What is the most appropriate treatment at this time?
Platelet rich plasma injection
Proximal medial opening wedge of first metatarsal
Dorsal exostectomy of the midfoot
Double calcaneal osteotomy with lateral column lengthening
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