The Department of Orthopaedic Surgery's Micheal Johnson, M.D., recently co-authored a paper entitled "Forefoot Supination and Medial Column Instability in the Setting of AAFD: The Role of the Medial Column" in Techniques in Foot and Ankle Surgery.

The paper explores the variables that may contribute to adult-acquired flatfoot deformities. Johnson highlights the role of the medial column of the foot and its role in stabilizing the foot as it is subjected to bare a considerable amount of weight while walking. The research examines the pathologies that can disrupt the normal foot mechanics surrounding the medial column and lead to flatfoot deformity while offering stabilization and joint-sparing techniques that may be used to correct and preserve foot mechanics.

Abstract: Several variables may contribute to adult-acquired flatfoot deformity, one such variable is the medial column of the foot, which commonly manifest as forefoot varus or supination. The medial column is subjected to considerable loads during gait, and under normal conditions provides dynamic stability during the stance phase of gait. Pathology occurring along the medial column and forefoot can disrupt normal foot mechanics and lead to flatfoot deformity. A careful history and examination can diagnose dysfunction relating to the medial column and forefoot. Specifically, first tarsometatarsal dysfunction can result in malalignment, and loss of first ray stability. It is important to consider all potential sources of medial column insufficiency since dysfunction can occur at any point along its course. Stabilization and joint-sparing techniques may be used to correct multiplanar malalignment of the firsttarsometatarsal joint, and offers a powerful means of preserving foot mechanics.

Read the full paper here.