Determining the Contribution of the Gastrocnemius and Soleus to a “Tight Heel Cord”
Note: Acceptable dorsiflexion depends on the health of the foot/ankle tissues, presenting problem, and severity
Example: Healthy runner with no foot problems and no dorsiflexion does not require release
Example: Midfoot DJD requires 25° to 30° dorsiflexion from the release to protect the mid-foot
Medial Column Changes Seen on a Weightbearing X-Ray
Pitfall: Nonweightbearing lateral foot X-rays may look normal
Trick: Take weightbearing lateral X-rays with knee extended and 10° forward lean. Use axes as reference for assessing deformity
Procedures for Stage II Flat Foot Surgery
Medial Calcaneal Osteotomy
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