The medial double arthrodesis includes arthrodesis of the subtalar and talonavicular joints and is rapidly overtaking the traditional standard triple arthrodesis as the preferred surgical treatment of rigid late stage pes planovalgus deformity. Both procedures share similar indications; however, a growing body of evidence is showing improved outcomes following medial double fusion. The corrective strength of the medial double is powerful, yet the calcaneal cuboid joint is allowed to remain mobile. The surgical technique is reproducible. The joints to be fused are easily accessed and visualized. The postreduction medial side soft tissue redundancy allows for improved incision healing, especially when compared to laterally based, tension side, incisions. Surgeons are embracing the decreased operating room time, less extensive dissection, decreased hardware needs, and equivocal or improved outcomes of the medial double when compared to triple arthrodesis. What follows is a chapter dedicated to the medial double arthrodesis including a step-by-step surgical technique.
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