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2Principles

Blood supply

Maintain columnar length and relationship

Medial column length is crucial in maintaining the shape of the medial arch of the foot.
If the navicular injury has resulted in comminution with loss of length, in reconstruction we must regain length, as well as normal geometry. Bridging the hardware distally and using bone graft will assure proper length of the medial column, overall shape and alignment of the foot.
The form and function of the foot is dependent on the normal relationship between the medial and lateral columns. If the relative lengths of the medial and lateral columns are not maintained, foot deformity such as cavus or planus results.
Relative shortening of the medial column leads to cavus whereas relative shortening of the lateral column leads to flat foot.