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Tenosynovectomy followed by UCBL orthotic use
1%
29/3407
Dwyer closing wedge calcaneal osteotomy, 1st metatarsal closing wedge osteotomy, and plantar fasica release
43/3407
Medial calcaneal displacement osteotomy, lateral column lengthening, FDL tendon transfer, and tendoachilles lengthening
86%
2916/3407
Arthrodesis of the subtalar, talonavicular, and calcaneocuboid
51/3407
Lateral calcaneal displacement osteotomy, FDL tendon transfer, and tendoachilles lengthening
10%
348/3407
Select Answer to see Preferred Response
This patient presents with a Stage 2B acquired flatfoot deformity. The review articles by Myerson and Pinney discuss the classification and management of adult acquired flatfoot deformity. Stage 1 presents with medial ankle pain due to posterior tibial tendon synovitis. Stage 2 presents with a hindfoot in valgus and inability to perform a single limb heel rise. Stage 2A has a normal forefoot whereas Stage 2B has an abducted forefoot, exposing “too many toes” when the foot is viewed posteriorly. Stage 3 occurs over time as the hindfoot becomes rigid in a valgus position and Stage 4 develops as the deltoid ligament becomes incompetent and the talus tilts into valgus. Incorrect Answers: 1: Tenosynovectomy can be used in Stage 1 disease that fails conservative management. 2: This is used as a treatment for cavovarus feet. 4: This option is a treatment option for Stage 3 disease. 5: This is not an option as a lateral displacement calcaneal osteotomy would exacerbate the patient's hindfoot valgus.
4.3
(27)
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