Este protocolo aborda a deformidade de pé plano adquirido flexível no adulto (AAFD) na qual as deformidades permanecem passivamente corrigíveis. A apresentação é caracterizada por colapso do arco longitudinal medial, abdução do antepé, aumento da descobertura talonavicular e valgo do retropé — um padrão consistente com AAFD flexível Estágio II.
O protocolo prevê correção cirúrgica triplana — uma abordagem que aborda a deformidade em múltiplos níveis do pé simultaneamente. Os procedimentos são selecionados para tratar cada componente da deformidade, com a combinação específica e o sequenciamento detalhados no 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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