The Flexible Planovalgus Foot

Extensive important propaedeutic considerations for evaluation and treatment indication of this frequent pediatric entity are put in front of the detailed presentation of an algorithm for surgical options. The pathomorphology, clinical presentation, spontaneous course, late prognosis, standardized radiologic, and pedographic evaluation are taken into account thoroughly. The radiologic TMT Index invented by the author provides a useful tool to quantitatively evaluate planovalgus deformity. Techniques following the principles of guided growth (arthroereisis) are presented as minimally invasive solutions for the late growing age with many treatment examples. For adolescence, three-dimensional correction can be achieved best by tarsal triple osteotomy (TTO) invented by the author as a routine procedure and has proven to be superior to a single osteotomy approach. An intermediate group may be treated successfully by an arthroereisis osteotomy combination (AOC). Selected fusions of the tarsometatarsal region are indicated for severe hypermobility.