Vol. 7, Issue 1, Part B (2025)

Background: Adult Acquired Flatfoot Deformity (AAFFD) is a progressive disorder primarily caused by posterior tibial tendon dysfunction, resulting in collapse of the medial longitudinal arch and hindfoot valgus, leading to impaired mobility and reduced quality of life. Surgical management varies by stage, especially for advanced deformities.
Objective: To evaluate the clinical and radiological outcomes of soft tissue surgical management without bony reconstruction in patients with stage III AAFFD.
Methods: This prospective observational study included 40 patients with stage III AAFFD treated by soft tissue procedures alone. Patients were assessed preoperatively and followed for 12 months postoperatively. Outcomes measured included the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and radiographic parameters (Meary’s angle, calcaneal pitch, talocalcaneal angle).
Results: The mean AOFAS score improved significantly from 52.4 ± 8.7 preoperatively to 85.7 ± 6.2 at 12 months (p<0.001), indicating marked pain relief and functional improvement. Radiographic angles remained stable, demonstrating deformity arrest without significant correction. Complications were minimal, with two superficial infections managed successfully and no tendon transfer failures or neurovascular injuries.
Conclusion: Soft tissue surgical management without bony procedures provides effective pain relief and functional restoration while stabilizing deformity in stage III AAFFD patients, especially those unfit for or reluctant to undergo extensive surgery. This approach offers a safe, lower morbidity alternative with favorable short-term outcomes. Further studies are needed to determine long-term efficacy and compare with combined reconstructive techniques.