Midfoot arthrodesis: challenges and treatment alternatives.

Arthrodesis and realignment of complex deformities of the midfoot requires thorough preoperative evaluation, exacting intraoperative technique, and vigilant postoperative management to achieve a successful functional outcome. An appreciation of the bony and soft-tissue factors contributing to the deformity facilitates a satisfactory functional outcome. Stable fixation in multiple planes with judicious bone grafting achieves union with the most complex deformities and severe bone loss.