Adult-acquired flatfoot deformity (AAFD) is composed of multi-structure problems. Failure of tendons, capsular, and other ligamentous structures lead to significant deformity and disability. Several therapeutic approaches are used to treat this disease. Arthrodesis reconstruction type procedure was raised as a satisfactory operation with high patient satisfaction. Ability to reduce most severe and fix deformities made it a procedure of choice in dealing with advance stage AAFD. Malunion, nonunion, lateral wound breakdown, and adjacent joint osteoarthritis are leading problems associated with this operation. However, there are some situations that patient will be best undergone these operations. Realigned triple arthrodesis along with its modifications are currently wide-accepted treatment for rigid arthritic flatfoot. Severe flexible AAFD and failed flatfoot reconstruction while choosing patients properly are also possible indications to treat with the fusion techniques. Lastly, some specific patient factors (age, morbid obesity, preexisting degenerative joint disease, and neuropathic patients) could be important factors to influence type of operations.
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