Management of the Rigid Arthritic Flatfoot in Adults: Triple Arthrodesis

Traditional surgical treatment for adults with a rigid, arthritic flatfoot is dual-incision triple arthrodesis, which has proved reliable and reproducible. Early complications include lateral wound problems, malunion, and nonunion. Long-term follow-up has shown adjacent joint arthritis at the ankle or midfoot. Although indications and surgical techniques have evolved and improved, it should be regarded as a salvage procedure. It requires preoperative planning, meticulous preparation of bony surfaces, cognizance of hindfoot positioning, and rigidity of fixation, as well as enough experience on the part of the operating surgeon to anticipate postoperative problems and provide modifications in traditional technique.