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Modified Grice-Green Subtalar Arthrodesis in Adults With Flatfoot

March 01, 2019

Contributors: Giuseppe Geraci, MD; Antonio Mazzotti, MD; Alessandro Panciera, MD; Francesco Pardo, MD; Fabrizio Perna; Federico Pilla, MD; Alberto Ruffilli, MD, PhD; Niccolò Stefanini, MD; Cesare Faldini, MD; Cesare Faldini, MD

2019 AWARD WINNER Morphologically, flatfoot is a deformity characterized by a reduction or absence of the medial plantar arch, talar adduction, plantar flexion, a valgus hindfoot with weight-bearing, varying degrees of forefoot supination and abduction, and posteromedial soft-tissue dysfunction. Functionally, flatfoot involves prevalent or persistent pronation during all phases of gait. Modified Grice-Green subtalar arthrodesis is a versatile procedure that can be used for the management of multiple pathologic conditions. Grice-Green subtalar arthrodesis, which was first described in 1950, involved extra-articular arthrodesis for the management of a limited number of pathologic conditions. Current indications are broader, and adult flatfoot deformity is one of the primary indications for the procedure. Subtalar arthrodesis for the management of adult flatfoot allows for hindfoot realignment and recovery of a normal plantar arch. This video demonstrates modified Grice-Green arthrodesis and discusses the outcomes of 109 consecutive adults with flatfoot who underwent modified Grice-Green subtalar arthrodesis. The procedure is shown using high-definition intraoperative footage and anatomic tables. Modified Grice-Green arthrodesis is safe and reproducible, resulting in good outcomes in appropriately indicated patients.

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