Key Insights On Conservative Care For Adult Flatfoot

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Author(s): 
Patrick DeHeer, DPM, FACFAS, FASPS, and Aaron Warnock, DPM

Final Words

Formulating a proper non-surgical treatment plan for an adult flatfoot can be challenging although many patients with an adult flatfoot in association with PTTD can have effective treatment with conservative management protocols as we have described above. At first patient contact, the clinician’s goal should be to alleviate or significantly decrease the patient’s pain and discomfort. When this happens, the clinician should institute long-term treatment options to decrease the progression of the deformity and limit future discomfort.

   Dr. DeHeer is a Fellow of the American College of Foot and Ankle Surgeons, a Fellow and member of the Board of Directors of the American Society of Podiatric Surgeons, and 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. Warnock graduated in 2013 from the Kent State University College of Podiatric Medicine and is completing a preceptorship with Dr. DeHeer.

References

1. Van Boerum D, Sangeorzan B. Biomechanics and pathophysiology of flat foot. Foot Ankle Clin. 2003; 8(3):419-430.
2. Myerson MS. Adult acquired flat foot deformity. J Bone Joint Surg Am. 1996; 78(5):780–92.
3. Johnson C, Christensen J. Biomechanics of the first ray part V: the effect of equinus deformity a 3-dimensional kinematic study on a cadaver model. J Foot Ankle Surg. 2005; 44(1):114-120.
4. Johnson KA, Strom DE. Tibialis posterior tendon dysfunction. Clin Orthop Rel Res. 1989; 239:196-206.
5. Sizensky J, Marks R. Medial-sided bony procedures: why, what and how? Foot Ankle Clin. 2003; 8(3):539-562.
6. Myerson MS. Adult-acquired flatfoot deformity: treatment of dysfunction of the posterior tibial tendon. Instr Course Lect. 1997; 46:393–405.
7. Lee MS, Vanore JV, Thomas JL, et al. Diagnosis and treatment of adult acquired flatfoot. J Foot Ankle Surg. 2005; 44(2):78–113.
8. Blake R, Ferguson H. Foot orthoses for severe flatfoot in sports. J Am Pod Med Assoc. 1991; 81(10):549-55.
9. Augustin JF, Sheldon SL, Berberian WS, Johnson JE. Nonoperative treatment of adult acquired flat foot with the Arizona Brace. Foot Ankle Clin. 2003; 8(3):491-502.
10. Noll K. The use of orthotic devices in adult acquired flatfoot deformity. Foot Ankle Clin. 2001; 6(1):25-36.
11. Meehan RE, Brage M. Adult acquired flat foot deformity: clinical and radiographic examination. Foot Ankle Clin. 2003; 8(3):431-452.

   For further reading, see “A Guide To Conservative Care For Adult Flatfoot” in the January 2011 issue of Podiatry Today or the DPM Blog “Why Conservative Treatment Is The Standard Of Care For Adult-Acquired Flatfoot” at http://tinyurl.com/43fsr3u . For an enhanced online experience, check out Podiatry Today on your iPad or Android tablet.

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