This manuscript describes a modified medial column arthrodesis involving the medial and intermediate naviculocuneiform joints, the first metatarsocuneiform joint and the first intercuneiform joint. Medial column stabilizing procedures are usually advocated as a component part of a generalized hypermobile flatfoot repair. This procedure, however, is being recommended for elderly or sedentary individuals who have medial column pain, difficulty ambulating and problems wearing standard foot gear secondary to end-stage medial column degenerative joint disease and medial column collapse.