China
Africa
Explore chapters and articles related to this topic
Pes plano valgus
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Manuel Monteagudo, Pilar Martínez de Albornoz, Maneesh Bhatia
Although initially believed to be the final common pathway due to posterior tibial tendon dysfunction (PTTD), the progression of the condition is multifactorial. Symptomatic PPV may develop from a pre-existing flatfoot or from a normal foot that flattens and becomes painful in adulthood (adult acquired flatfoot deformity – AAFD). The terms PPV, PTTD and AAFD are often used interchangeably in the literature. The common finding is the collapse of the medial arch of the foot with pain in the medial soft tissues including posterior tibial tendon (PTT) and progressive deformity in the midfoot and forefoot. PPV affects women more frequently than men, with peak age of 55 years (1). A pre-existing flatfoot is present in most patients, with other risk factors including obesity, diabetes, hypertension, treatment with steroids and impact sports (2). Physical examination is the key to diagnose PPV, but imaging studies are necessary to exclude arthritis as this finding may influence the choice of treatment. Despite classifications that help to guide the management, no two PPV cases are the same so every patient should be addressed in terms of the type of deformity and risk factors to individualise conservative and surgical treatment.
Pathoanatomy of congenital clubfoot
Published in R. L. Mittal, Clubfoot, 2018
Turco,4 discussed and highlighted his clinical observations that the majority of failures occurred when surgery was performed early, at less than one year of age (6 out of 10 of his own cases) and also when they are operated on after 6 years of age. Surgery is best performed at 1–2 years of age. As the child grows, deformity may increase and require triple arthrodesis in children over 8 years of age. Surgery in children older than this age should be done in selected cases, when skin is pliable and all tarsal joints are good and well preserved. He has reported iatrogenic talar abnormalities during conservative treatment due to excessive pressure and more fibrosis in prolonged conservative treatment in more severe deformities. He has also stressed pes planus due to overcorrections after complete releases. In surgery of rocker-bottom footed patients, flat foot resulted more often. He also reported skew-foot deformity with valgus as well as metatarsus adductus.
Planovalgus deformity
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
Apart from flatfoot associated with hypermobile joint syndrome there are a few other causes of mobile flatfoot. Isolated paralysis of the tibialis posterior muscle can result in a planovalgus deformity. Contracture of the gastrocsoleus is another cause of flatfoot.
Towards patient-specific medializing calcaneal osteotomy for adult flatfoot: a finite element study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Zhongkui Wang, Masamitsu Kido, Kan Imai, Kazuya Ikoma, Shinichi Hirai
Flatfoot is a common foot deformity in which the medial longitudinal foot arch collapses resulting in complete or near-complete contact with the ground. Flatfoot sufferers may develop lower extremity pain, ankle swelling, and walking difficulty (McCormack et al. 2001). In early stages, a single surgery, such as medializing calcaneal osteotomy (MCO), can relieve the symptoms. However, in severe cases, combined corrections, such as a combination of MCO and lateral column lengthening (LCL), are usually required clinically. A recent review of surgical treatments for flatfoot can be found in Gestel et al. (2015). Despite its commonality, the biomechanics of flatfoot is not fully understood, and the methodology for achieving patient-specific surgery has not been well established.
Effect of 3D printed insoles for people with flatfeet: A systematic review
Published in Assistive Technology, 2023
Aliyeh Daryabor, Toshiki Kobayashi, Hassan Saeedi, Samuel M. Lyons, Noriaki Maeda, Sedigheh Sadat Naimi
Flatfoot (pes planus) is described as feet with visually dropped medial longitudinal arches and is often associated with rearfoot eversion and forefoot abduction. Specifically, the arch is observable during non-weight-bearing conditions but becomes invisible under bodyweight. Individuals with flatfeet often complain of foot pain and fatigue after walking and occasionally experience associated ankle (Ellis et al., 2010) and knee pain (Gross et al., 2011), which results in a decline in the quality of life (Pita-Fernandez et al., 2017).
Effects of selective strengthening of tibialis posterior and stretching of iliopsoas on navicular drop, dynamic balance, and lower limb muscle activity in pronated feet: A randomized clinical trial
Published in The Physician and Sportsmedicine, 2019
Farhan Alam, Shahid Raza, Jamal Ali Moiz, Pooja Bhati, Shahnawaz Anwer, Ahmad Alghadir
Pesplanus, commonly known as ‘flatfoot,’ is a common pathomechanical condition characterized by a lowered medial longitudinal arch (MLA) with rear foot eversion [1,2] and exaggerated pronation [3]. Primarily, two variants of flatfoot have been described: rigid and flexible; the latter is more prevalent [4]. A previous study reported that 20% of the adult population have flatfeet [5], and 12.8% of adults with flatfeet are males and 14.4% are females [6]. Pronated foot is a debilitating condition that has been shown to affect health-related quality of life and functionality [7] and could result in the development of compensatory pathomechanical conditions in different parts of the body, i.e. from the feet to the lower back [8,9]. Moreover, pronated foot is associated with the occurrence of musculoskeletal disorders, such as plantar fasciitis [10], chronic plantar heel pain [11], Achilles tendinopathy [12], medial tibial stress syndrome [13], knee osteoarthritis (OA) [14], and low back pain (LBP) [15]. Particularly, flatfoot has been considered a primary risk factor for LBP and knee OA as lowered MLA applies abnormal forces to these joints over time [14,15]. Pronated feet are characterized by adduction with medial rotation of the talus, eversion of the calcaneus, and supination with abduction of the forefoot [16,17]. These biomechanical alterations increase internal rotation of the tibia and femur with excessive anterior titling of the pelvis, which is compensated by increased lumbar lordosis and thoracic kyphosis and is suggested to be potential contributors of LBP [15]. Furthermore, excessive internal rotation of the lower limb in patients with pronated feet has been shown to increase mechanical stresses across the knee, possibly resulting in increased rotational stress on the load-bearing tissues of the tibio-femoral compartments. Moreover, these mechanical changes are associated with increased contact between the articulating surfaces of the lateral patella and the lateral trochlear femoris, thereby making flatfoot a major cause of knee OA [14].