A Guide To Conservative Care For Adult Flatfoot
- Volume 24 - Issue 1 - January 2011
- 14247 reads
- 0 comments
Conservative treatment is often able to decrease pain and the progression of flatfoot deformity. Early detection and treatment of posterior tibial tendon dysfunction can keep the deformity from progressing to further stages in the adult flatfoot scheme. Therefore, it is important to do a thorough history and physical exam with radiographic studies. Surgical correction is indicated for both complete posterior tibial tendon rupture and progressive deformity of the foot.
Should tenosynovitis persist after an extended period of conservative treatment, one should consider surgical correction as well. It is important to evaluate the patient thoroughly to be certain that one has explored the proper treatment methods.
Dr. DeHeer is a Fellow of the American College of Foot and Ankle Surgeons, and is a Diplomate of the American Board of Podiatric Surgery. He is also a team podiatrist for the Indiana Pacers and the Indiana Fever. Dr. DeHeer is in private practice with various offices in Indianapolis.
Dr. Taulman is a first-year resident at Westview Hospital in Indianapolis.
1. Sferra JJ, Rosenberg GA. Nonoperative treatment of posterior tibial tendon pathology. Foot Ankle Clin 1997; 2(2):261-273.
2. Pomeroy GC, Pike RH, Beals TC, Manoli A. Acquired flatfoot in adults due to dysfunction of the posterior tibial tendon. J Bone Joint Surg 1999; 81(8):1172-83.
3. Slovenkai MP. Clinical and radiographic evaluation. Foot Ankle Clin 1997; 2:241-260.
4. Mann RA. Biomechanics of the foot. In (Bowker JH, Michael JW, eds.): Atlas of Orthotics: Biomechanical Principles and Application. CV Mosby, St. Louis, 1975, p. 264.
5. Mann RA. Rupture of the tibialis posterior tendon. Instr Course Lect 1984; 33:302-309.
6. Sarrafian SK. Anatomy of the Foot and Ankle. J.B. Lippincott, Philadelphia, 1983, pp. 173-174.
7. Funk DA, Cass JR, Johnson KA. Acquired adult flat foot secondary to posterior tibial tendon pathology. J Bone Joint Surg 1986; 68(1):95-102.
8. Mann RA, Thompson FM. Rupture of the posterior tibial tendon causing flat foot. J Bone Joint Surg 1985; 67(4):556-561.
9. Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop Rel Res 1989; 239:197.
10. Myerson M. Adult acquired flatfoot deformity. Treatment of dysfunction of the posterior tibial tendon. J Bone Joint Surg 1996; 78A:780-92.
11. Conti S, Michelson J, Jahss M. Clinical significance of magnetic resonance imaging in preoperative planning for reconstruction of posterior tibial tendon ruptures. Foot Ankle 1992; 13(4):208-214.
12. Noll KH. The use of orthotic devices in adult acquired flatfoot deformity. Foot Ankle Clin 2001; 6(1):25-36.
13. Bare AA, Haddad SL. Tenosynovitis of the posterior tibial tendon. Foot Ankle Clin 2001; 6(1):37-66.
14. Marzano R. Functional bracing of the adult acquired flatfoot. Clin Podiatr Med Surg 2007; 24(4):645-656.
15. McCormack AP, Ching RP, Sangeorzan BJ. Biomechanics of procedures used in adult flatfoot deformity. Foot Ankle Clin 2001; 6(1):15-23.
16. Thordarson DB, Schmotzer H, Chon J, Peters J. Dynamic support of the human longitudinal arch. A biomechanical evaluation. Clin Orthop Relat Res. 1995; 316:165-72.
17. Mizel MS, Temple HT, Scranton PE Jr, et al. Role of the peroneal tendons in the production of the deformed foot with posterior tibial tendon deficiency. Foot Ankle Int. 1999; 20(5):285-9.
18. Elftman NW. Nonsurgical treatment of adult acquired flatfoot deformity. Foot Ankle Clin N Am 2003; 8(3):473-489.
19. Richie DH. Biomechanics and clinical analysis of the adult acquired flatfoot. Clin Podiatr Med Surg 2007; 24(4):617-644.