Managing the adult flexible flatfoot deformity

The past, present and the future: an evolution of thinking

Abstract

There is a varied spectrum to the flexible flatfoot deformity. This article aims to elucidate the senior authors classification and treatment algorithm for this condition. Although there are several ways of dealing with this condition, the main aim should be to correct the three components of heel valgus, tendon/muscle imbalance and forefoot supination. We have had good results with a novel technique of reconstructing the PTT, however this is only anecdotal. Further studies delineating the outcomes of PTT allograft reconstruction need to be performed. Future research should focus on outcomes and how they relate to preoperative MRI. It also remains to be determined what the optimal tension is for these grafts.