Marengo Asia Hospital (Formerly Sunshine Global Hospital), Vadodaranr. Shreyas Vidhyalay, behind ICICI Bank, Lalbaug, Manjalpur, Vadodara, Gujarat 390004 / Marengo Asia Hospital (Formerly Sunshine Global Hospital), SuratDumas Rd, beside Big Bazar, Piplod, Surat, Gujarat 395007
Revision Surgery
Reconstructing a Failed Triple Fusion for Flat Foot
A rigid flat foot reconstruction after a failed in-situ fusion — correcting deformity first, then re-fusing in the functional position with full muscle balancing.
Patient Age
19 Years
MECHANISM
Failed prior fusion
PRESENTATION
6 Years of Pain After Prior Fusion
APPROACH
Dwyer/MDCO, Three-Plane Osteotomy, Deltoid Reconstruction
01
Clinical Rationale
An earlier in-situ fusion locked a rigid flat foot into deformity rather than correcting it. Every component — heel valgus, midfoot abduction, forefoot supination — had to be corrected first, and only then re-fused in the functional position.
02
Surgical Approach
Correction preceded fusion: a Dwyer/MDCO with plantarwards displacement, peroneal tenotomy, three-plane osteotomy at the talonavicular joints (medial closed wedge, pronation, plantar-based wedge) and deltoid reconstruction — re-fusing in the functional position.
02
Imaging & Progression
Pre-operative and post-operative imaging documenting deformity correction and fusion. Each slot maps to a CMS image field — drop in the matching consented file from the case folder.
#1
For a rigid flat foot, fusions must be done in the functional position, never in situ.
#2
Fusion should always follow deformity correction — in-situ fusion leads to disaster.
#3
Muscle balancing is equally vital to a durable correction.
#4
Every component deformity — heel valgus, midfoot abduction, forefoot supination — must be individually addressed.
04
Clinical Care Points
RIGHT SIDE
- i) Dwyer/MDCO with plantar displacement
ii) Peroneal tenotomy
iii) Three-plane TN osteotomy
iv) Deltoid reconstruction
LEFT SIDE
-
| 35+ YEARS OF TRUST, CARE & EXCELLENCE
Reconstructing a Failed Triple Fusion for Flat Foot
A rigid flat foot reconstruction after a failed in-situ fusion — correcting deformity first, then re-fusing in the functional position with full muscle balancing.
A 19-year-old man had painful bilateral peroneal-spastic flatfeet, with the left side causing greater disability. He previously underwent attempted subtalar and calcaneocuboid fusion with an additional ankle screw, but the screw was later removed and the foot remained painful and deformed for three years. The failed operation left him with a rigid foot that was fused in a poor functional position.
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