J Korean Foot Ankle Soc.  2016 Mar;20(1):6-11. 10.14193/jkfas.2016.20.1.6.

Treatment of Flatfoot Deformity

• Lee DO
• Jung HG

• KMID: 2158421
• DOI: http://doi.org/10.14193/jkfas.2016.20.1.6

Abstract

Flatfoot deformity, defined as loss of medial longitudinal arch, sometimes involves symptoms such as medial arch pain or Achilles tendon tightening, etc. Whether the etiology of deformity is congenital or acquired, i.e., posterior tibial tendon dysfunction, symptoms are largely resolved with conservative treatment including medication, orthoses, and activity modification. Surgery should be considered in cases of failure of conservative treatment and clinicians can select an appropriate technique among many surgical options including calcaneal osteotomy or flexor digitorum longus tendon transfer. Principles of corrective surgery include the recovery of alignment and the preservation of joint motion.

Keyword

Flatfoot; Conservative treatment; Surgical procedure

MeSH Terms

Achilles Tendon
Congenital Abnormalities*
Flatfoot*
Joints
Orthotic Devices
Osteotomy
Posterior Tibial Tendon Dysfunction
Tendon Transfer

Figure

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  Figure 1. Flexor digitorum longus (FDL) transfer procedure. (A) Photograph shows isolated FDL tendon. Drilling at the navicular tuberosity (B), then tenodesis is performed Fig. 1C and D.

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  Figure 2. Fluoroscopy shows medial sliding calcaneal osteotomy at sagittal view (A) and axial view (B).

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  Figure 3. (A) Interpositional allo-bone graft was performed at calcaneal anterior process. (B) Postoperative lateral standing radiograph shows elevated calcaneal pitch after lateral column lengthening.

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  Figure 4. Preoperative flatfoot deformity (A) was improved after subtalar arthroereisis (B).

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  Figure 5. Multiple arthritic change with severe deformity (A) usually requires triple arthrodesis procedure (B).

Reference

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