posted on 27 Mar 2015 19:41 by lisadogge

Adult-acquired flatfoot or collapsed arch occurs since the large tendon around the inside with the ankle - the particular posterior tibial tendon - becomes stretched out as well as no more sports ths foot?s arch. in many cases, the actual issue worsens as well as as well as the tendon thickens, becoming painful, specifically during activities. Flatfoot or even collapsed arch is also known as posterior tibial tendon dysfunction. This particular situation is unique compared to getting flat feet since birth (known as congenital flatfoot), although sometimes these patients develop comparable symptoms and call for comparable treatments.

Adult Acquired Flat Foot


Causes associated with an adult acquired flatfoot might include Neuropathic foot (Charcot foot) secondary to become able to Diabetes mellitus, Leprosy, Profound peripheral neuritis regarding virtually any cause. Degenerative changes inside the ankle, talonavicular or perhaps tarsometatarsal joints, or both, secondary for you to Inflammatory arthropathy, Osteoarthropathy, Fractures, Acquired flatfoot resulting through loss in the supporting structures with the medial longitudinal arch. Dysfunction of the tibialis posterior tendon Tear of the spring (calcaneoanvicular) ligament (rare). Tibialis anterior rupture (rare). Painful flatfoot may possess additional causes, such as tarsal coalition, but as this sort of patient will not existing having a alter within the form of the particular foot these are not included here.


Not everyone together with adult flatfoot features issues with pain. those who do typically go through it around the ankle or within the heel. The Particular pain can be usually even worse using activity, like walking or standing for extended periods. Sometimes, if the condition develops through arthritis inside the foot, bony spurs along the top as well as side of the foot develop along with create wearing shoes a lot more painful. Diabetic patients need to watch pertaining to swelling or perhaps big lumps within the feet, while they might not recognize any kind of pain. These People are also at higher risk with regard to developing significant deformities via their flatfoot.


First, each feet ought in order to be analyzed using the individual standing and the entire lower extremity visible. The Particular foot should be inspected coming from above also as from powering the particular patient, as valgus angulation of the hindfoot is best appreciated when the foot is actually viewed from behind. Johnson described your so-called more-toes sign: with more advanced deformity and also abduction of the forefoot, really the actual lateral toes turn out in order to be visible when the foot is actually viewed through behind. Your single-limb heel-rise test is definitely an excellent determinant of the function of the posterior tibial tendon. The Particular affected person can be inspired to attempt to rise on the ball of just one foot whilst the other foot will be suspended off your floor. Below typical circumstances, the posterior tibial muscle, which usually inverts and stabilizes the actual hindfoot, can be activated since the patient begins to rise to the forefoot. Your gastrocnemius-soleus muscle mass group then elevates the actual calcaneus, and in addition the heel-rise will be accomplished. with dysfunction of the posterior tibial tendon, however, inversion in the heel can be weak, and also possibly your heel remains within valgus or perhaps the affected person is unable to rise onto the forefoot. When the individual could perform a single-limb heel-rise, your limb might be stressed further simply by asking the particular individual to execute this maneuver repetitively.

Non surgical Treatment

Nonoperative treatment of posterior tibial tendon dysfunction can achieve success using the Arizona AFO brace, particularly when treatment method is actually initiated within the initial phases with the disease. This specific mandates that the orthopedist features a high index involving suspicion when evaluating patients to produce an accurate diagnosis. Though there's a role with regard to surgical management regarding acquired flat feet, a well-fitted, custom-molded leather as well as polypropylene orthosis can be efficient from relieving signs as well as symptoms and also both obviating or even delaying just about any surgical intervention. Throughout today's climate of patient fulfillment directed well being care, any much less invasive therapy modality which relieves pain might prove to become worth more than comparable pain relief that's obtained following surgery. questions relating to the actual long-term results of bracing remain unanswered. future studies are usually required to see whether disease progression and arthrosis occur despite symptomatic relief with a brace. Furthermore, age- and disease stage-matched manage groups who are randomized in order to endure surgery or bracing are generally essential to compare these various therapy modalities.

Adult Acquired Flat Foot

Surgical Treatment

For patients using a more severe deformity, or even significant symptoms that won't respond to be able to conservative treatment, surgery might be necessary. You will find several procedures available depending around the naturel of one's condition. Ligament along with muscle lengthening, removal of inflamed tendon lining, transferring of a close by tendon in order to re-establish an arch, as well as bone realignment as well as fusion are examples regarding surgical options to assist with a painful flatfoot condition. Surgery may be ignored when signs are generally addressed early. In the particular event that you might be sensation ankle pain or even notice just about any warmth, redness or even swelling inside your foot, call us immediately. We may create a tailored treatment program to solve your own signs along with avoid long term problems.