Este protocolo aborda la deformidad por pie plano adquirido en el adulto (AAFD) flexible, en la que las deformidades permanecen corregibles pasivamente. La presentación se caracteriza por el colapso del arco longitudinal medial, la abducción del antepié, el aumento del descubrimiento talonavicular y el valgo del retropié — un patrón consistente con el estadio II del AAFD flexible.
El protocolo indica una corrección quirúrgica triplanar, un enfoque que aborda la deformidad en múltiples niveles del pie de forma simultánea. Los procedimientos se seleccionan para tratar cada componente de la deformidad, con la combinación específica y la secuencia detalladas en el protocolo completo.
Triplane correction should be considered when addressing the flexible AAFD.
Stage II flexible AAFD is characterized by a range of passively correctable deformities including collapse of the medial longitudinal arch, forefoot abduction, increased talonavicular uncovering, and hindfoot valgus.
Medial displacement calcaneal osteotomy should be considered in cases of flexible adult-acquired flatfoot correction.
Arangio and Salathe demonstrated through biomechanical models that performing a 10-mm medial displacement of the calcaneus can restore normal loading across the talonavicular joint to levels of a rectus foot posture.
Stage IIB AAFD often requires a lateral column lengthening procedure to address forefoot abduction.
The investigators concluded that an opening wedge medial cuneiform osteotomy is an important adjunctive procedure to correct the forefoot varus component of a flatfoot deformity.
Correction of deformity at all levels is required to achieve a stable plantigrade foot.
They reported that improved (Foot and Ankle Outcome Score) pain scores were better in those corrected to mild hindfoot varus.
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