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Surgical Decision Making in the Management of Adult-Acquired Flatfoot Deformity
Few clinical conditions possess as much inherent heterogeneity as adult-acquired flatfoot deformity (AAFD). The degree of flexibility of the foot, the severity and location of deformity, the presence of forefoot supination, and the degree of arthritic change are but a few of the factors that contribute to a wide and variable spectrum of disease. This clinical heterogeneity and the equally expansive array of surgical techniques and philosophies, particularly for the management of flexible stage II AAFD, can cause confusion and uncertainty for the patient and surgeon alike. The purpose of this chapter is to address common surgical decisions that are encountered during treatment of AAFD and provide a framework for the decision-making process that will lead to predictable and successful outcomes.