Flatfoot is the term used to describe a weight-bearing foot shape in which the hindfoot is in valgus alignment, the midfoot sags in a plantar direction with reversal of the longitudinal arch, and the forefoot is supinated in relation to the hindfoot. There is no agreement on strict clinical or radiographic criteria for defining a flatfoot. Therefore, the point beyond which a foot with a low normal arch becomes defined as a flatfoot is unknown. Nonsurgical treatment options include education, orthotics, and achilles tendon stretching programs.

This article reviews the pathophysiology and clinical presentation of flatfoot and reviews considerations in mangement. The specfic surgical technique of calcaneal lengthening osteotomy is discussed in detail in this article.

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