Flatfoot Deformity

Description

In this informative surgical video, Dr. Scott Ellis, an orthopedic surgeon specializing in foot and ankle surgeries at the Hospital for Special Surgery, guides viewers through a complex flat foot reconstruction procedure. The patient is suffering from a collapsing flat foot deformity with an associated coalition, prompting the need for a subtalar joint fusion alongside other corrective techniques such as an FDL transfer and a cotton osteotomy.



Dr. Ellis begins by explaining the surgical plan, emphasizing the unique challenges presented by the patient's condition, including the rigid hind foot and lateral pain due to impingement. He details the initial steps of the surgery, including a gastroc recession to alleviate tightness in the Achilles tendon and performing electrocautery while carefully avoiding damage to nearby blood vessels.



The surgery is meticulously documented, showcasing the approaches to the posterior tibial tendon and the careful dissection required to navigate around critical structures. Dr. Ellis utilizes a series of specialized instruments to prepare the subtalar joint for fusion, explaining the importance of joint preparation to ensure a successful outcome. He performs a fusion through a sinus tarsi approach, removing ligaments and preparing the joint surfaces to promote healing.



As surgery progresses, Dr. Ellis addresses hindfoot valgus correction by translating the heel over, providing insights into the techniques used for bone stabilization and the anticipated outcomes for the patient. He employs a calcaneal osteotomy as part of the correction process to alleviate the patient's symptoms



In the final parts of the video, Dr. Ellis conducts the FDL transfer and secures the first ray using a cotton osteotomy for optimal alignment. He concludes the operation with repairs to the spring ligament and the removal of a spur which was causing discomfort to the patient. Post-operative care and recovery expectations are also discussed, setting the stage for the patient's healing journey.



This video serves as an excellent educational resource for those interested in orthopedic surgery, particularly conditions related to flat foot deformities.

Specialties