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- Flat foot = pes planus = pes planovalgus
- Flat foot occurs due to flattening of one or more of the arches of the foot
- Due to muscle insufficiency or failing capsules and ligaments
- Flat foot can occur in children and in adults
- The arches of the feet develop a while after birth – flatfoot in newborns is normal
- Etiology
- Increased bodyweight
- Being forced to stand early as a baby (too early walking age)
- Standing all day at work
- Bad shoes
- Old age
- Types of flat foot
- Pes transversoplanus – flat transverse arch
- Pes planus – flat longitudinal arch
- Clinical features
- In children
- Pain in muscles of the thigh and calf after activity
- Due to the muscles actively working to correct the flatfoot
- In adults
- Pain in the area of the flat arch during activity
- In adults the muscles have given up trying to correct the flatfoot
- Heel valgus
- Pes transversoplanus -> wide forefoot
- When tip-toeing a non-fixed flatfoot will gain back the arch
- Prevention
- Don’t let your child walk too early (before 1 year)
- Preventative muscle exercises
- Tickle baby feet
- Prevent obesity
- Treatment
- Conservative
- Heel wedge – corrects heel valgus
- Arch support
- Arch support is not treatment – they will cause do the job of the muscles, causing them to get weaker
- Arch support can prevent pain but does not treat the underlying flatfoot
- Surgical: Calcaneo-stop procedure
- A screw is drilled into the calcaneus
- The screw causes discomfort to the patient -> this forces the patient to use their muscles to correct their foot
- Complications:
- Pes planus fixatus (= fixed flatfoot)
- Due to tarsal coalition (fusion of tarsal bones), which occurs secondary to untreated flatfoot or as a developmental malformation
- When tip-toeing a fixed flatfoot will not gain back the arch
- Tarsal coalitions can be resected surgically
- Hallux valgus
- Bunion
- Hammertoe
- Osteoarthritis
