Title : The Really Bad Flatfoot
Although an abundance of research into the treatment of adult-acquired flatfoot deformity (AAFD) has led to improved standardization of surgical options, discrepancies still exist in how surgeons approach this common musculoskeletal condition. These differences in surgical approaches appear to be based on geographic location and training. As other conditions became included as part of the umbrella of adult-acquired flatfoot deformity, including posterior tibial tendon rupture, peritalar instability, osteoarthritis of the pedal joint structures, dorsolateral peritalar subluxation (PTS), and progressive talipes equinovalgus, these conditions also involve pathologic damage of the supporting structures, including the superficial and deep deltoid, talonavicular, spring, cervical and interosseous ligaments. This further adds to nomenclature confusion and treatment. As a result, a newer classification includes these extended pathologic conditions, described as progressive collapsing foot deformity (PCFD). PCFD represents a complex 3-dimensional deformity with varying degrees of rearfoot valgus, forefoot abduction, and midfoot varus. This oral presentation offer insights into surgical management of AAFD and PCFD with ten case presentations which provide a stepwise approach to assessing a patient, considering their unique biomechanics and determining necessary procedures that would benefit their anatomy.