Subtalar arthroereisis. Valente procedure.

The Valente procedure is a technically improved version of the original subtalar arthroereisis idea of LeLevre. It involves the control of pronation in a selective type of flatfoot deformity in which the predominant pathology is seen within the subtalar joint. Careful workup is necessary to prevent performing this procedure in flatfeet when other procedures, such as arthrodesis or calcaneal osteotomy, would produce better results. In choosing the proper implant, it is important to allow some pronation of the joint (usually 3 to 4 degrees). Failure to do so can result in complications, such as sinus tarsitis, adductovarus deformity, or dislodging of the implant. The procedure is effective in the treatment of painful flatfoot deformity if the guidelines for patient selection, operative technique, and postoperative care, as presented here, are followed.