The catchy latinized term "paradoxical pes planus varus" has unwittingly perpetuated the notion of obligatory heel varus in Müller-Weiss disease. Evidence shows that heel varus is not always the rule. Furthermore, the medial arch does not sag in Maceira stages II and III. It only sags in stages IV and V. Hence, the term should be restricted to instances where both heel varus and flatfoot are present, a combination that is much less common than that of heel valgus and flatfoot. Presence of hindfoot varus can be confirmed radiologically before embarking on lateral displacement calcaneal osteotomy.
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McKenna et al. (2024) studied this question.
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