What Are The Primary Causes Of Adult Aquired Flat Feet ?

posted on 20 Apr 2015 23:50 by ossifiedsaga2773
Overview
The adult acquired flatfoot (AAF) is a progressive, symptomatic (painful) deformity resulting from gradual stretch (attenuation) of the tibialis posterior tendon as well as the ligaments that support the arch of the foot. Although the posterior tibialis tendon plays a significant role, this pathology has recently been recognized as involving failure of other interosseous ligaments, such as the spring ligament. Due to the complexity of this pathology, posterior tibial tendon dysfunction (PTTD) is now referred to as adult acquired flatfoot. Severe flatfoot associated with AAF can lead to other problems, such as plantar fascial tension, tendon pain, rearfoot subluxation, and ankle osteoarthritis. Acquired Flat Feet

Causes
There are a number of theories as to why the tendon becomes inflamed and stops working. It may be related to the poor blood supply within the tendon. Increasing age, inflammatory arthritis, diabetes and obesity have been found to be causes.

Symptoms
Pain along the inside of the foot and ankle, where the tendon lies. This may or may not be associated with swelling in the area. Pain that is worse with activity. High-intensity or high-impact activities, such as running, can be very difficult. Some patients can have trouble walking or standing for a long time. Pain on the outside of the ankle. When the foot collapses, the heel bone may shift to a new position outwards. This can put pressure on the outside ankle bone. The same type of pain is found in arthritis in the back of the foot. Asymmetrical collapsing of the medial arch on the affected side.

Diagnosis
The diagnosis of tibialis posterior dysfunction is essentially clinical. However, plain radiographs of the foot and ankle are useful for assessing the degree of deformity and to confirm the presence or absence of degenerative changes in the subtalar and ankle articulations. The radiographs are also useful to exclude other causes of an acquired flatfoot deformity. The most useful radiographs are bilateral anteroposterior and lateral radiographs of the foot and a mortise (true anteroposterior) view of the ankle. All radiographs should be done with the patient standing. In most cases we see no role for magnetic resonance imaging or ultrasonography, as the diagnosis can be made clinically.

Non surgical Treatment
This condition may be treated with conservative methods. These can include orthotic devices, special shoes, and bracing. Physical therapy, rest, ice, and anti-inflammatory medication may be prescribed to help relieve symptoms. If the condition is very severe, surgical treatment may be needed. Acquired Flat Feet

Surgical Treatment
If conservative treatment fails to provide relief of pain and disability then surgery is considered. Numerous factors determine whether a patient is a surgical candidate. They include age, obesity, diabetes, vascular status, and the ability to be compliant with post-operative care. Surgery usually requires a prolonged period of nonweightbearing immobilization. Total recovery ranges from 3 months to one year. Clinical, x-ray, and MRI examination are all used to select the appropriate surgical procedure.
Tags: adult, aquired, flat, foot