Adult rigid flatfoot: Triple arthrodesis and osteotomy

To analyze the efficacy of arthrodesis combined with osteotomy applied to subtalar, calcaneocuboid, and talonavicular joints for the treatment of adult rigid flatfoot. This retrospective study included 29 adult patients with rigid flatfoot who underwent triple arthrodesis combined with osteotomy from January 2015 to December 2017. All patients suffered from stage III of adult acquired flatfoot. Patients returned for a clinical and radiologic follow-up evaluation at an average of 19.5 (range, 15–27) months postoperatively. Outcomes were assessed by comparing pre- and postoperative AOFAS scores, VAS pain scores, and Karlsson scores, and the radiographic assessment including Meary, Pitch, and Kite angles. Twenty six patients returned for final evaluation. Twenty four patients had an excellent or good outcome on patient subjective self-assessment. All the VAS scores, AOFAS scores, and Karlsson scores at final follow-up showed different extents of improvement. The mean Meary angle significantly decreased from 25.8 ± 5.4 degrees preoperatively to 6.9 ± 7.7 degrees at final follow-up, and the mean Pitch angle improved markedly from 12.5 ± 3.7 points preoperatively to 23.2 ± 4.1 points at final follow-up (P < .001). Arthrodesis combined with osteotomy can effectively correct calcaneal valgus deformity, restore arch structure, and relieve foot pain in adult rigid flatfoot.