A new surgical procedure for the treatment of severe structural flatfoot with forefoot varus is presented. The talar osteotomy for flatfoot deformity and the pathology in the talus with medial column forefoot varus is described. The flatfoot considerations, adjunctive deformities, and the surgical reduction are presented. The talar osteotomy has been performed on 47 feet with a follow-up that is intermediate in length from 1 to 7 years. The results indicate that the procedure is specific and allows for good reduction when indicated in the majority of the cases.
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