Reconstruction preserving the talonavicular and subtalar joints for flexible rocker-bottom foot deformity in rheumatoid arthritis.

A patient with rheumatoid arthritis and a flexible rocker-bottom foot deformity underwent surgery, including a flexor digitorum longus transfer, a spring ligament reconstruction, and a lateral column lengthening using calcaneocuboid distraction arthrodesis, while preserving the talonavicular and subtalar joints. Correction was achieved with the restoration of the medial longitudinal arch, and clinical outcome scores had improved at the final follow-up (1 year postoperatively). This case suggests that, even in patients with inflammatory joint diseases presenting with a rocker-bottom foot deformity, reconstruction preserving the talonavicular and subtalar joints may be considered as a treatment option when disease activity is adequately controlled with pharmacotherapy and the talonavicular and subtalar joints are not destroyed, as in the present case.