Surgical Management of Posttraumatic Midfoot Deformity and Arthritis

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Posttraumatic joint disruption and deformity remains one of the most common etiologies for midfoot degenerative joint disease. Patients presenting with midfoot arthritis commonly complain of increased pain with weight-bearing activity, and tenderness over the dorsum of the foot with constrictive shoe wear secondary to dorsal osteophyte formation. Nonoperative measures assist with symptom control, focusing on limiting both pain and deformity. Operative intervention is generally considered after an adequate trial of nonoperative measures. Arthrodesis procedures remain the “gold standard” for operative treatment of midfoot arthritis. Interpositional tendon arthroplasty of the fourth and fifth tarsometatarsal joints has been supported as a motion-sparing alternative to arthrodesis for patients with lateral column disease. The indications, complications, postoperative management, and techniques for posttraumatic midfoot arthritis procedures are discussed in further detail below.

Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence.

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