Lawrence Fallat, DMP, FACFAS – A 52-year-old female with arthritic pain and significant lowering of the right arch, was treated with Acumed’s ExtremiLock Foot H Plate, ExtremiFix Cannulated Screws, and the InstaFix Staple System. Patient History: A 52-year-old female complained of pain to her right foot for several years. Pain was graded at 7/10 on a daily basis, and progressively increasing. No history of trauma. The patient failed conservative care, including NSAIDs, steroid injections, oral steroids, orthotics, braces, and physical therapy. Physical Examination: A physical exam showed mild edema, dorsal medial at the talonavicular joint. In stance, the patient had a rearfoot valgus position of 12°. She had 10° of subtalar inversion and 0° of eversion. A musculoskeletal exam revealed an equinus of 20° with her knee extended. With flexion of her knee, the foot could be brought into dorsiflexion at a 90° angle to her leg, indicating a gastrocnemius contracture. In stance, she had significant lowering of her right arch. She had pain to palpation at the talonavicular (TN) joint and at the sinus tarsi.