Surgery: Hindfoot Valgus

Severe hindfoot valgus correction: arthroereisis, osteotomies for rigid or symptomatic cases. Dr. Priano, Milan.

Surgical correction for severe hindfoot malalignment

Surgical Techniques

Subtalar Arthroereisis

Minimally invasive insertion of an implant in the sinus tarsi to limit excessive pronation and correct hindfoot valgus. Same procedure as for flatfoot.

Indication

Symptomatic flexible hindfoot valgus in children 8-14 years not responding to conservative treatment.

Recovery

No cast. Progressive weight bearing. Implant removal after 2-3 years.

Medializing Calcaneal Osteotomy

Correction of severe hindfoot valgus through displacement of the calcaneus to restore normal alignment.

Indication

Severe rigid hindfoot valgus, failed arthroereisis, older adolescents.

Recovery

Cast for 6 weeks. Progressive weight bearing. Full recovery 3 months.

Postoperative Overview

Hindfoot valgus treatment follows similar principles to flatfoot correction. The choice between arthroereisis and osteotomy depends on flexibility, severity, and patient age.

Detailed Recovery Timeline

Note: The timeline below is a general baseline. The actual postoperative course varies depending on the specific surgical technique chosen (see procedures above).

Day-surgery for arthroereisis. 1 night for osteotomy.

Arthroereisis: Same as flatfoot protocol. Osteotomy: Non-weight bearing cast for 3-4 weeks.

Arthroereisis: Full weight bearing by week 2-3. Osteotomy: Progressive weight bearing in walking boot.

Full activities resumed. Custom orthotics if indicated.