Do I Suffer Adult Aquired Flat Foot ?

Overview

There are four stages of posterior tibial tendon dysfunction. In the first stage the posterior tibial tendon is inflamed but has normal strength. There is little to no change in the arch of the foot. In stage two the tendon is partially torn or shows degenerative changes and as a result loses strength. There is considerable flattening of the arch without arthritic changes in the foot. Stage three results when the posterior tibial tendon is torn and not functioning. As a result the arch is completely collapsed with arthritic changes in the foot. Stage four is identical to stage three except that the ankle joint also becomes arthritic.Flat Feet




Causes

Women are affected by Adult Acquired Flatfoot four times more frequently than men. Adult Flatfoot generally occurs in middle to older age people. Most people who acquire the condition already have flat feet. One arch begins to flatten more, then pain and swelling develop on the inside of the ankle. This condition generally affects only one foot. It is unclear why women are affected more often than men. But factors that may increase your risk of Adult Flatfoot include diabetes, hypertension, and obesity.




Symptoms

The first stage represents inflammation and symptoms originating from an irritated posterior tibial tendon, which is still functional. Stage two is characterized by a change in the alignment of the foot noted on observation while standing (see above photos). The deformity is supple meaning the foot is freely movable and a ?normal? position can be restored by the examiner. Stage two is also associated with the inability to perform a single-leg heel rise. The third stage is dysfunction of the posterior tibial tendon is a flatfoot deformity that becomes stiff because of arthritis. Prolonged deformity causes irritation to the involved joints resulting in arthritis. The fourth phase is a flatfoot deformity either supple (stage two) or stiff (stage 3) with involvement of the ankle joint. This occurs when the deltoid ligament, the major supporting structure on the inside of the ankle, fails to provide support. The ankle becomes unstable and will demonstrate a tilted appearance on X-ray. Failure of the deltoid ligament results from an inward displacement of the weight bearing forces. When prolonged, this change can lead to ankle arthritis. The vast majority of patients with acquired adult flatfoot deformity are stage 2 by the time they seek treatment from a physician.




Diagnosis

Observation by a skilled foot clinician and a hands-on evaluation of the foot and ankle is the most accurate diagnostic technique. Your Dallas foot doctor may have you do a walking examination (the most reliable way to check for the deformity). During walking, the affected foot appears more pronated and deformed. Your podiatrist may do muscle testing to look for strength deficiencies. During a single foot raise test, the foot doctor will ask you to rise up on the tip of your toes while keeping your unaffected foot off the ground. If your posterior tendon has been attenuated or ruptured, you will be unable to lift your heel off the floor. In less severe cases, it is possible to rise onto your toes, but your heel will not invert normally. X-rays are not always helpful as a diagnostic tool for Adult Flatfoot because both feet will generally demonstrate a deformity. MRI (magnetic resonance imaging) may show tendon injury and inflammation, but can?t always be relied on for a complete diagnosis. In most cases, a MRI is not necessary to diagnose a posterior tibial tendon injury. An ultrasound may also be used to confirm the deformity, but is usually not required for an initial diagnosis.




Non surgical Treatment

Initial treatment consists of supporting the medial longitudinal arch (running the length of the foot) to relieve strain on the medial soft tissues. The most effective way to relieve pain on the tendon is to use a boot or brace, and once tenderness and pain has resolved, an orthotic device. A boot, brace, or orthotic has not been shown to correct or even prevent the progression of deformity. Orthotics can alleviate symptoms and may slow the progression of deformity, particularly if mild. The deformity may progress despite orthotics.

Adult Acquired Flat Feet




Surgical Treatment

Flatfoot reconstruction (osteotomy). This is often recommended for flexible flatfoot condition. Flatfoot reconstruction involves cutting and shifting the heel bone into a more neutral position, transferring the tendon used to flex the lesser toes (all but the big toe) to strengthen the posterior tibial tendon, and lengthening the calf muscle. Fusion (also known as triple arthrodesis). Fusion involves fusing, or making stiff, three joints in the back of the foot the subtalar, talonavicular, and calcaneocuboid joints, to realign the foot and give it a more natural shape. Pins or screws hold the area in place until it heals. Fusion is often recommended for a rigid flatfoot deformity or evidence of arthritis. Both of these surgeries can provide excellent pain relief and correction.

Write a comment

Comments: 19
  • #1

    Obat Herbal Psoriasis di Kepala (Tuesday, 15 November 2016 01:03)

    Psoriasis in the head called Psoriasis Scalp Psoriasis is a look at the hairline, head like dandruff but more and also looked at around the forehead, around the neck, behind the ear to treat psoriasis

  • #2

    psychics online (Tuesday, 13 December 2016 10:04)

    Maćczak

  • #3

    wróżka (Wednesday, 14 December 2016 05:34)

    Grodkowice

  • #4

    psychic readings (Thursday, 15 December 2016)

    algeria

  • #5

    seks telefon 24h (Monday, 19 December 2016 11:56)

    proportionate

  • #6

    uroki miłosne (Wednesday, 28 December 2016 17:42)

    squeezer

  • #7

    anonse erotyczne (Thursday, 29 December 2016 05:54)

    uniwalent

  • #8

    sextel (Wednesday, 11 January 2017 05:35)

    niebabrającym

  • #9

    liebeszauber (Friday, 13 January 2017 03:23)

    wyartykułować

  • #10

    sextelefon (Thursday, 19 January 2017 01:12)

    niepopodkładany

  • #11

    psychic reading (Friday, 20 January 2017 08:25)

    ełkaesowiec

  • #12

    love magic (Saturday, 21 January 2017 10:39)

    Demski

  • #13

    rytuał miłosny (Monday, 10 April 2017 05:47)

    rytuał miłosny

  • #14

    seks anonse (Tuesday, 05 September 2017 04:33)

    AF

  • #15

    dziewczyny na seks (Friday, 08 September 2017 10:00)

    nierozważenie

  • #16

    sex przez telefon (Saturday, 09 September 2017 03:46)

    pośrednik

  • #17

    sex przez telefon (Friday, 06 October 2017 05:31)

    zamiarując

  • #18

    sex telefon (Friday, 13 October 2017 09:30)

    szmuklerstwo

  • #19

    seksu przez telefon (Friday, 20 October 2017 09:14)

    strojowy