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Category: Volume 10 Issue 03 March 2022
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Title: Anatomical Basis of Flat Foot

Authors: Davinder Singh, Jasbir Kaur, Sunil Dhanger, Tharani Peela, Vandana Mehta

 DOI: https://dx.doi.org/10.18535/jmscr/v10i3.22

Abstract

Pes planus also referred to as flat foot, planovalgus foot or fallen arches refers to the loss of medial longitudinal arch of foot. As a result the foot either comes closer to the ground or makes contact with the ground. The condition can be either congenital or acquired. Congenital flatfoot occurs due to ligamentous laxity and lack of neuromuscular control(5). Acquired flatfoot occurs most frequently secondary to dysfunction of posterior tibial tendon(6).

The medial longitudinal arch formed by calcaneus, talus, navicular, cuneiform and medial three metatarsals is higher, tougher and elastic compared to the lateral counterpart thus allowing it to vary dynamically in shape and configuration during gait.  It gives more resilience to the medial part of the foot and also facilitates propulsive action. It acts as a support for the entire body and helps to transmit the body weight to the ground. It also stores energy during the gait cycle.  Dysfunction of medial longitudinal arch can result in alteration of lower limb biomechanics as well as lumbar spine resulting in enhanced risk of pain and injury(1).

References

  1. Marc A. Raj , Dawood Tafti , John Kiel , NCBI Bookshelf , A service of the National library of medicine, National institutes of health
  2. Michaudet C, Edenfield KM, Nicolette GW, Carek Foot and ankle Conditions:  Pes Planus. FP Essent. 2018 Feb : 465 : 18-23( Pubmed : 29381041)
  3. Kitaoka HB, Ahn TK, Luo ZP, An KN. Stability of the arch of foot. Foot Ankle Int. 1997 Oct: 18(10); 644-8 (Pubmed: 9347302)
  4. Halabchi F, Mazaheri R, Mirshahi M, Abbasian L. Pediatric flexible flatfoot: Clinical aspects and algorithm approach . Iran J Pediatr. 2013 June 23(3):247-60.( Pub med: 23795246)
  5. Nemeth B. The diagnosis and management of common childhood orthopedic disorders. Curr Probl Pediatr Adolesc Health Care. 2011 Jan 41(1): 2-28.(Pubmed : 21195338)
  6. Bubra PS, Keighley, Rateesh S, Carmody D. Posterior tibial tendon dysfuntion : an overlooked cause of foot deformity. J Family Med Prim Care. 2015 Jan –Mar 4(1): 26-9 .PMC free article : PMC 43670019( Pubmed 25810985)
  7. Kohls- Gatzoulis J, Woods B, ANGEL JC, Singh D. The prevalence of symptomatic posterior tibialis dysfuntion in women over the age of 40 in England. FOOT Ankle Surg. 2009: 15(2): 75-81. (Pubmed: 19410173)
  8. Ross JA. Posterior Tibial tendon dysfunction in the athlete. ClinPodiatr Med Surg. 1997 Jul 14(3): 479-88 ( Pubmed : 9257
  9. Gwani AS, Asari MA, Mohd Ismail ZI. How the three arches of the foot intercorrelate. Folia Morphol (warsz). 2017: 76(4): 682-688.
  10. Karasick D, Schweitzer ME. Tear of the posterior tibial tendon causing asymmetric flat foot : radiologic findings. AJR Am j roentgenol 1993: 161(6): 1237-40.
  11. Perotti LR, Abousamra O, Del Pilar Duque Orozco, Roger’s KJ, Sees JP, Miller F. Foot and ankle deformities in children with Down syndrome . j child Orthop. 2018 Jun 01, 12( 3); 218-226.
  12. Lindsey JM, Michelson JD, Mac Williams BA, Spnseller PD, Miller NH . The foot in Marfansyndrome: clinical findings and weight distribution patterns. J pediatr Orthop.1998 Nov-dec 18 (6)755-9.
  13. Shirley ED, DEmaio M, Bodurtha J. Ehlers-danlos syndrome in orthopedics: etiology, diagnosis and treatment implications. Sports health .2012 Sep: 4(5): 393-403.
  14. Uden H, Scharfbiling R. The typically developing paediatric foot: how flat should it be ? A systematic review. J foot Ankle Res 2017 : 10 (1): 37.
  15. Poko J, Guszcyn t, Kwiatkowski M , Komarnicki B. Peditric flat feet. Pol J appl Sci 2017: 3(1):20-25.
  16. Carr JB 2nd, Yang S, Lather LA. Pediatric pes planus : A state of the art review. Pediatrics 2016: 137 (3): e20151230.
  17. Gould N, Moreland M, Alvarez R, Trevino S, Fenwick j. Developemnt of child’s arh. Foot ankle 1989 : 9(5) 241-245.
  18. Ling SK, LUI th. Posterior tibial tendon dysfunction : An overview . Open Orthop J 2017: 11 :714-723.
  19. Lever CJ, , hennessy MS. Adult flat foot deformity: ORTHOP trauma 2016: 30(1): 41-50.
  20. Gajendran VK, Yoo BJ, Hunter JC . Unusual variant of the nutcracker fracture of calcaneus and tarsal navicular. Radiol.case REP. 2008: 3(3):208.
  21. Penner MJ. Late reconstruction after navicular fracture. Foot ANKLE CLIN. 2006 > mar 11(1): 105-19 .ix. ( Pubmed 1654456).
  22. Munro BJ, Steele JR. foot – care awareness. A survey of persons aged 65 years and older. J Am Podiatr Med 1998 MAY : 88 ( 5): 242-8.
  23. Otsuka R, YatsuyaH, Miura Y, Murata C, Tamakoshi K, Oshiro K, Nishion  N,  Ishikawa M,  Zhang HM, Shizozawa M, Kobayashi A, Ito M, Hori Y, Kondo T, Toyoshima H. Association of flatfoot with pain ,  fatigue and obesity in Japanese over sixties. Nihon Koshu Eisei Zasshi. 2003 Oct: 50 (10): 988-98.
  24. Lauterbach S, Kostev K, Becker R. Characterstics of diabetic patients visiting a podiatry practice in Germany. J Wound care. 2020Apr: 19(4): 140,142, 144 Passim.
  25. Pita- Fernandez S, Gonzalez- Martin C,  Alopnso- Tajes F, Seoane- Pillado T, Pertega- Diaz S, Perez – GARCIA s, seijo – bestilleiro R, Balboa- barreiro V. flat foot in a random population andits impact on quality of life and functionality . Population and its impact on quality of life and functionality. J clin Diagn Res. 2017.
  26. Van Boerum DH, Sangeorzan BJ. Biomechanics and pathophysiology of flat foot. Foot Ankle Clin2003: 8(3) : 419-430 .
  27. Chhabra A, Soldatos T, Chalian M et al . 3-Tesla magnetic resonance imaging evaluation of posterior tibial tendon dysfunction with relevance to clinical staging. J Foot Ankle Surg 2011: 50(3): 320-328.

Corresponding Author

Jasbir Kaur