Dealing with the rheumatoid midfoot and hindfoot is a challenging endeavor. There are numerous perioperative factors that influence surgical outcomes. This article provides a brief overview of the disease process and pertinent details on the surgical management of the rheumatoid midfoot and hindfoot. The pathophysiology, clinical presentation, imaging, conservative treatment options, perioperative management, and surgical intervention for rheumatoid midfoot and hindfoot disease are discussed, with special attention to primary arthrodesis for midfoot and hindfoot reconstruction in the rheumatoid patient, which has been the mainstay of treatment for the last 100 years.
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