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Rigid flatfoot

So Young Ahn, Soo Kyung Bok, Bong Ok Kim, In Sik Park
BACKGROUND: A talus control foot orthosis (TCFO) combines an inverted rigid foot orthosis (RFO) with a broad upright portion that rises well above the navicular to cover and protect the talonavicular joint. We sought to identify the therapeutic effect of TCFOs in children with flexible flatfoot. METHODS: Flexible flatfoot was diagnosed in 40 children when either of the feet had greater than 4° valgus of resting calcaneal stance position (RCSP) angle and one of the radiographic indicators was greater than 30° in anteroposterior talocalcaneal angles, 45° in lateral talocalcaneal angles, and 4° in lateral talometatarsal angles and less than 10° of calcaneal pitch in barefoot radiographs...
January 2017: Journal of the American Podiatric Medical Association
Jaime Rice Denning
Tarsal coalition (a congenital fibrous, cartilaginous, or bony connection between two bones) classically presents with recurrent ankle sprains or with insidious onset of a painful, stiff flatfoot. Flatfoot is a benign finding most of the time, but it is important to distinguish the rigid flatfoot from the flexible flatfoot. A patient with recurrent sprains of the ankle or a stiff flatfoot should be evaluated for a tarsal coalition. The key to making the diagnosis is careful examination for stiffness in the subtalar joint and appropriate imaging studies...
April 2016: Pediatric Annals
Emily A Quinn, Kyle S Peterson, Christopher F Hyer
Calcaneonavicular coalitions can lead to a painful, rigid pes planovalgus deformity. Historical treatment of coalitions recommends resection. A newer concept in coalition treatment includes concomitant flatfoot reconstruction. In the present study, we hoped to demonstrate the ability to reconstruct a flatfoot deformity with concomitant calcaneonavicular coalition resection. We performed a retrospective comparative study of patients undergoing isolated calcaneonavicular bar excision (group A) with those undergoing calcaneonavicular bar excision and concomitant pes planovalgus reconstruction (group B)...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
James B Carr, Scott Yang, Leigh Ann Lather
Flatfoot (pes planus) is common in infants and children and often resolves by adolescence. Thus, flatfoot is described as physiologic because it is usually flexible, painless, and of no functional consequence. In rare instances, flatfoot can become painful or rigid, which may be a sign of underlying foot pathology, including arthritis or tarsal coalition. Despite its prevalence, there is no standard definition for pediatric flatfoot. Furthermore, there are no large, prospective studies that compare the natural history of idiopathic, flexible flat feet throughout development in response to various treatments...
March 2016: Pediatrics
Jacob Wynes, Bradley M Lamm, Anil Bhave, Randa K Elmallah, Michael A Mont
The authors present the case of an 81-year-old man who, despite an anatomically aligned total knee arthroplasty, continued to have knee pain. The patient's ipsilateral rigid flatfoot caused by an earlier partial pedal amputation resulted in a valgus moment during gait, thus creating clinical symptoms in the total knee arthroplasty. Because of the deformity and scarring within the flatfoot, this valgus deformity was corrected through a varus distal femoral osteotomy. The result was normalization of the mechanical axis of the lower limb and a pain-free total knee arthroplasty with an excellent clinical outcome...
January 2016: Orthopedics
Abdel Majid Sheikh Taha, David S Feldman
Flatfoot is commonly encountered by pediatric orthopedic surgeons and pediatricians. A paucity of literature exists on how to define a flatfoot. The absence of the medial arch with a valgus hindfoot is the hallmark of this pathology. Flatfoot can be flexible or rigid. This review focuses on the diagnosis and treatment of the flexible flatfoot. Most flatfeet are flexible and clinically asymptomatic, and warrant little intervention. If feet are symptomatic, treatment is needed. Most patients who require treatment improve with foot orthotics and exercises...
December 2015: Foot and Ankle Clinics
Kathryn Bauer, Vincent S Mosca, Lewis E Zionts
BACKGROUND: Children with flatfeet are frequently referred to pediatric orthopaedic clinics. Most of these patients are asymptomatic and require no treatment. Care must be taken to differentiate patients with flexible flatfeet from those with rigid deformity that may have underlying pathology and have need of treatment. Rigid flatfeet in infants may be attributable to a congenital vertical talus (CVT); whereas those in older children and adolescents may be due to an underlying tarsal coalition...
December 2016: Journal of Pediatric Orthopedics
B Hintermann
OBJECTIVE: Lengthening of the lateral column for adduction of forefoot and restoration of the medial arch. Stabilization of the ankle joint complex. INDICATIONS: Supple flatfoot deformity (posterior tibial tendon dysfunction stage II). Instability of the medial ankle joint complex (superficial deltoid and spring ligament). Posttraumatic valgus and pronation deformity of the foot. CONTRAINDICATIONS: Rigid flatfoot deformity (posterior tibial tendon dysfunction stage III and IV)...
August 2015: Operative Orthopädie und Traumatologie
Yu Cheng, Huilin Yang, Li Ni, Dawei Song, Hongtao Zhang
The increase in proportional loading of the fibula with progression of hindfoot deformity would lead to high fibular loads during rapid walking, resulting in insufficiency fractures. We report an unusual mechanism of such fracture in a textile worker resulting from valgus alignment from a stage III flatfoot deformity. The stress fracture was missed initially and only confirmed by CT examination. The patient responded well to nonoperative treatment and had an excellent recovery with no residual symptoms finally...
2015: International Journal of Clinical and Experimental Medicine
Markus Knupp, Lukas Zwicky, Tamara Horn Lang, Julian Röhm, Beat Hintermann
The medial approach to the subtalar joint allows good visualization of the articular surfaces. Compared with the lateral approach, advantages are found particularly in flatfoot correction, in which the single-incision technique can be used for corrective fusions of rigid flatfoot deformity. Union rates are comparable with the traditional lateral approach; however, wound healing problems occur less frequently. Avascular necrosis of the talus is a rare but serious complication, although frequency seems to be independent of the approach chosen...
June 2015: Foot and Ankle Clinics
J Röhm, L Zwicky, T Horn Lang, Y Salentiny, B Hintermann, M Knupp
Talonavicular and subtalar joint fusion through a medial incision (modified triple arthrodesis) has become an increasingly popular technique for treating symptomatic flatfoot deformity caused by posterior tibial tendon dysfunction. The purpose of this study was to look at its clinical and radiological mid- to long-term outcomes, including the rates of recurrent flatfoot deformity, nonunion and avascular necrosis of the dome of the talus. A total of 84 patients (96 feet) with a symptomatic rigid flatfoot deformity caused by posterior tibial tendon dysfunction were treated using a modified triple arthrodesis...
May 2015: Bone & Joint Journal
Jenny M Frances, David S Feldman
Flatfoot in a child may be normal before development of the arch, but the prevalence decreases with age. Treatment is indicated only in the presence of pain and should begin with nonsurgical management options such as stretching of the Achilles tendon and the use of soft shoe orthotics. If pain persists, a modified Evans procedure, together with additional procedures to address forefoot supination, can be successful in correcting deformity and addressing pain. A thorough understanding of the pathology and correction desired will help minimize complications and recurrence...
2015: Instructional Course Lectures
Bing Xie, Jing Tian, Xin-wei Liu, Da-peng Zhou, Liang-bi Xiang
OBJECTIVE: To evaluate the clinical outcome of accessory navicular fusion for treatment of the painful accessory navicular bone of type II in adults. METHODS: From June 2006 to June 2012, a total of 38 feet (in 35 adult patients) with painful accessory navicular with type I underwent an fusion operation of the primary and accessory navicular bones,including 26 males and 9 females with a mean age of (32.4±7.3) years old ranging from 18 to 44 years old. The course of disease ranged from 3 to 10 months...
October 2014: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Simon Fuk-Tan Tang, Chien-Hung Chen, Chih-Kuan Wu, Wei-Hsien Hong, Kuan-Jung Chen, Chih-Kuang Chen
The purpose of this study is to evaluate the therapeutic effect of total contact insole with forefoot medial posting (TCIFMP) orthosis in patients with flexible flatfoot. The TCIFMP insole was custom- mode, made from semi-rigid plastazote and PPT. Using the gait analysis and the plantar-pressure measure systems, we investigate rearfoot motion and plantar pressure redistribution in these patients. The results of this study showed that the excessive valgus movement of the rearfoot can be reduced significantly by the TCIFMP insole in these patients...
February 2015: Clinical Neurology and Neurosurgery
Jung Ryul Kim, Chan Il Park, Young Jae Moon, Sung Il Wang, Keun Sang Kwon
BACKGROUND: Accessory navicular can become symptomatic in childhood, and in some cases, the condition is associated with progressive flattening of the longitudinal arch. Moreover, some severe, rigid flatfoot deformities are associated with an accessory navicular. We investigated the results of concomitant calcaneo-cuboid-cuneiform osteotomies (triple C) and the modified Kidner procedure for severe flatfoot associated with a symptomatic accessory navicular in children and adolescents. METHODS: Twenty-one feet of 13 patients (nine boys, four girls; mean age 12...
2014: Journal of Orthopaedic Surgery and Research
E M Spratley, E A Matheis, C W Hayes, R S Adelaar, J S Wayne
A cohort of adult acquired flatfoot deformity rigid-body models was developed to investigate the effects of isolated tendon transfer with successive levels of medializing calcaneal osteotomy (MCO). Following IRB approval, six diagnosed flatfoot sufferers were subjected to magnetic resonance imaging (MRI) and their scans used to derive patient-specific models. Single-leg stance was modeled, constrained solely through physiologic joint contact, passive soft-tissue tension, extrinsic muscle force, body weight, and without assumptions of idealized mechanical joints...
August 2015: Annals of Biomedical Engineering
Maurizio De Pellegrin, Désirée Moharamzadeh, Walter Michael Strobl, Rainer Biedermann, Christian Tschauner, Thomas Wirth
PURPOSE: The aim of this study was to describe a subtalar extra-articular screw arthroereisis (SESA) technique for the correction of flexible flatfoot (FFF) in children and report the outcome. METHODS: From 1990 to 2012, data were collected on 485 patients who underwent SESA at the San Raffaele Hospital. The average age of the patient cohort was 11.5 ± 1.81 years (range 5.0-17.9 years; median 11.5 years). Inclusion criteria were FFF and marked flexible hindfoot valgus, and the exclusion criterion was rigid flatfoot...
December 2014: Journal of Children's Orthopaedics
Maryse Bouchard, Vincent S Mosca
Most children with flatfeet are asymptomatic and will never require treatment. In general, flatfoot deformity is flexible and will not cause pain or disability; it is a normal variant of foot shape. Thus, it is essential to reassure and educate patients and parents. A flatfoot with a contracture of the Achilles tendon may be painful. In these cases, a stretching program may help relieve pain. Scant convincing evidence exists to support the use of inserts or shoe modifications for effective relief of symptoms, and there is no evidence that those devices change the shape of the foot...
October 2014: Journal of the American Academy of Orthopaedic Surgeons
Lawrence A DiDomenico, Zachary M Thomas, Ramy Fahim
The clinical presentation of adult flatfoot can range from a flexible deformity with normal joint integrity to a rigid, arthritic flat foot. Debate still exists regarding the surgical management of stage II deformities, especially in the presence of medial column instability. This article reviews and discusses various surgical options for the correction of stage II flatfoot reconstructive procedures. The authors discuss their opinion that is not always necessary to transfer the flexor digitorum longus tendon to provide relief and stability in this patient population...
July 2014: Clinics in Podiatric Medicine and Surgery
Somaieh Payehdar, Hassan Saeedi, Amir Ahmadi, Mohammad Kamali, Maryam Mohammadi, Vahid Abdollah
BACKGROUND: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated. OBJECTIVES: The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot...
February 2016: Prosthetics and Orthotics International
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