Adult Acquired Flatfoot

Foot and Ankle: Core Knowledge in Orthopaedics

Volumn , Issue , 2007, Pages 38-57

  Lobo, Margaret ^a   Greisberg, Justin ^a  

^a Columbia University College of Physicians and Surgeons ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 74549151422     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1016/B978-0-323-03735-8.50010-8     Document Type: Chapter

References (16)

1. D Ananthakrisnan, R Ching, A Tencer, et al. (1999) Subluxation of the talocalcaneal joint in adults who have symptomatic flatfoot. J Bone Joint Surg 81-A 1147-1154. Using weight-bearing CT scans, the authors demonstrated subluxation of the subtalar facets with flatfoot, so that only about half of the joint was actually in contact.
2. W Chao, et al. (1996) Nonoperative management of posterior tibial tendon dysfunction. Foot Ankle Int 17(12), 736-741. Forty-nine patients with PTT dysfunction were treated with orthoses. Forty feet were treated with molded AFOs, and 13 feet were treated with UCBL shoe inserts with medial posting. The authors concluded that patients with PTT dysfunction can be treated by aggressive non-operative management, as 67% of patients had good to excellent results according to a functional scoring system based on pain, function, use of assistive device, distance of ambulation, and patient satisfaction.
3. TD Chi, et al. (1999) The lateral column lengthening and medial column stabilization procedures. Clin Orthop Relat Res 365 81-90. The results of medial column stabilization, lateral column lengthening, and combined medial and lateral procedures were reviewed. The study concluded that these procedures effectively correct deformity without disrupting the essential joints of the hindfoot and midfoot, by evaluating pain, function, and radiographic parameters.
4. B Hintermann (1995) [Dysfunction of the posterior tibial muscle due to tendon insufficiency]. Orthopade 24(3), 193-199. This is a review of the dynamic and static supports of the arch in which the focus is on posterior tibialis tendon dysfunction. It recommends early diagnosis and repair or supplementation of the tendon to prevent flatfoot deformity.
5. CK Huang, et al. (1993) Biomechanical evaluation of longitudinal arch stability. Foot Ankle 14(6), 353-357. This is a study of 12 cadaveric specimens that were loaded after sectioning of the plantar fascia, plantar ligaments, and spring ligament. The study found that the highest relative contribution to arch stability was provided by the plantar fascia, followed by plantar ligaments and spring ligament. The division of the plantar fascia decreased arch stiffness by 25%.
6. KA Johnson and DE Strom (1989) Tibialis posterior tendon dysfunction. Clin Orthop Relat Res 239 196-206. This paper introduces the staging system of PTT dysfunction. The pain symptoms, clinical signs, and roentgenographic changes for each of these stages are characteristic and reviewed.
7. P Kannus and L Jozsa (1991) Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73(10), 1507-1525. A histopathological study of 897 spontaneously ruptured tendons was performed and compared with 445 non-ruptured cadaveric tendons. The findings indicated that degenerative changes are common in the tendons of people who are older than 35 years, and that these changes are associated with spontaneous rupture.
8. ES Malicky, et al. (2002) Talocalcaneal and subfibular impingement in symptomatic flatfoot in adults. J Bone Joint Surg Am 84-A(11), 2005-2009. Nineteen patients with symptomatic flatfeet and lateral-sided pain were analyzed using CT and weight-bearing x-rays. The study concluded that impingement occurs first within the sinus tarsi and then may involve the calcaneofibular region.
9. RA Mann (2001) Posterior tibial tendon dysfunction. Treatment by flexor digitorum longus transfer. Foot Ankle Clin 6(1), vi. A review of the various methods to treat PTT dysfunction. The review focuses on FDL transfer in the attenuated PTT. 77-87.
10. MS Myerson, A Badekas and LC Schon (2004) Treatment of stage II posterior tibial tendon deficiency with flexor digitorum longus tendon transfer and calcaneal osteotomy. Foot Ankle Int 25(7), 445-450. A retrospective review of 129 patients treated with FDL transfer and medial calcaneal osteotomy for PTT dysfunction. The study concluded—based on radiographic, subjective measurements and function scores—that the procedure yielded excellent results, with minimal complications and a high patient satisfaction rate.
11. JA Papa and MS Myerson (1992) Pantalar and tibiotalocalcaneal arthrodesis for post-traumatic osteoarthrosis of the ankle and hindfoot. J Bone Joint Surg Am 74(7), 1042-1049. Twenty-one patients (13 had a tibiotalocalcaneal fusion and 8 had a pantalar fusion) were evaluated for pain, satisfaction, and return to work. The study found that patients who had had a tibiotalocalcaneal arthrodesis were more mobile and functioned at a higher level than those who had had a pantalar arthrodesis. It concluded that extended arthrodesis of the ankle and hindfoot should be regarded as a salvage operation capable of producing a satisfactory result and usually providing a reasonable alternative to amputation.
12. CL Saltzman, et al. (1999) Triple arthrodesis: twenty-five and forty-four-year average follow-up of the same patients. J Bone Joint Surg Am 81(10), 1391-1402. A long-term outcome study evaluating patient satisfaction and function following triple arthrodesis for numerous neuromuscular underlying conditions.
13. BJ Sangeorzan, V Mosca and ST Hansen Jr (1993) Effect of calcaneal lengthening on relationships among the hindfoot, midfoot, and forefoot. Foot Ankle 14(3), 136-141. Radiographic parameters of the flatfoot deformity were defined. These parameters were then used to evaluate the corrective power of a lateral column lengthening.
14. NA Sharkey, L Ferris and SW Donahue (1998) Biomechanical consequences of plantar fascial release or rupture during gait: Part I—Disruptions in longitudinal arch conformation. Foot Ankle Int 19(12), 812-820. This is a cadaveric study in which the effect of complete plantar fascia sectioning on arch height was analyzed. Radiographic measurements of height of the arch, base length of the arch, and talo-first metatarsal angle were used to assess contributions to arch support made by the plantar fascia, tibialis posterior, peroneus longus and brevis, and digital flexor muscles. Complete fasciotomy caused significant collapse of the arch in the sagittal plane.
15. RD Teasdall and KA Johnson (1994) Surgical treatment of stage I posterior tibial tendon dysfunction. Foot Ankle Int 15(12), 646-648. A review of 19 patients who underwent synovectomy and debridement for stage 1 PTT dysfunction. Seventy-four percent of patients had complete pain relief, and 84% of patients subjectively reported being “much better” and had a return of function. Two patients underwent subtalar arthrodesis for progressive foot deformity and continued pain.
16. BC Toolan, BJ Sangeorzan and ST Hansen Jr (1999) Complex reconstruction for the treatment of dorsolateral peritalar subluxation of the foot. Early results after distraction arthrodesis of the calcaneocuboid joint in conjunction with stabilization of, and transfer of the flexor digitorum longus tendon to, the midfoot to treat acquired pes planovalgus in adults. J Bone Joint Surg Am 81(11), 1545-1560. The functional and radiographic results of a painful, flexible flatfoot associated with attrition or rupture of the PTT were evaluated in 36 patients (41 feet) treated with calcaneocuboid distraction arthrodesis and medial soft tissue supplementation. The study concluded that relief of pain and the restoration of function achieved through effective correction of the severe pes planovalgus deformity accounted for the satisfactory outcomes in these patients.