CME OnDemand: 2021 Annual Meeting Instructional Course Lectures (ICLs)-Flatfoot: Too Much Is Never Enough

Video Transcription

Video Summary

The video discusses various surgical approaches for treating flatfoot deformity, focusing on posterior tibial dysfunction. The importance of understanding the continuum of deformity and tailoring treatment is emphasized. The first technique discussed is FDL tendon transfer to address arch collapse, along with the importance of addressing Achilles tendon position through a calcaneal osteotomy. Lateral column lengthening techniques are also explored, including osteotomies and metal wedges, with a focus on correcting forefoot abduction. The use of weight-bearing CT scans for better understanding deformity and planning surgery is emphasized. The importance of considering associated deformities and thoroughly assessing the patient's condition through physical examination, imaging, and symptom correlation is stressed. The speaker also introduces the concept of lateral column lengthening, mentioning a step cut osteotomy for stability and transverse arm bone-to-bone healing. A modified approach using one incision to combine lateral column lengthening and calc slide is discussed. The importance of assessing eversion motion, avoiding overcorrection, and watching procedures such as lapicot and FHL transfer and lengthening of the first ray is highlighted. Classification systems for different types of foot deformities, differentiating between flexible and rigid deformities, are explained. Case examples and surgical approaches for each case are provided.

Asset Subtitle

Moderator: Clifford L. Jeng, MD

Conservative Treatment: What Works and What Doesn’t - Irvin Oh, MD
Flexible Deformity: Which Procedures and Why? - Clifford L. Jeng, MD
Stage IV Flatfoot Management - Mark S. Myerson, MD
New Calcaneal and Midfoot Osteotomies - Keith L. Wapner, MD
Reconstruction vs. Fusion: Beyond Rigid vs. Flexible - Michael P. Clare, MD
I’ve Corrected Their Deformity... and They Still Hurt - Jonathan T. Deland, MD
Discussion

Keywords

surgical approaches

flatfoot deformity

posterior tibial dysfunction

arch collapse

Achilles tendon position

calcaneal osteotomy

lateral column lengthening

forefoot abduction

weight-bearing CT scans

associated deformities

physical examination

imaging

symptom correlation

step cut osteotomy

transverse arm bone-to-bone healing