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Ugeskrift For Laeger Jan 2023Pes planovalgus (PV) in early childhood is a common physiological state, and usually resolves throughout childhood. Parental concern often leads to seeking medical... (Review)
Review
Pes planovalgus (PV) in early childhood is a common physiological state, and usually resolves throughout childhood. Parental concern often leads to seeking medical advice. This review summarises the current knowledge of the different types of PV. Asymptomatic PV does not need treatment, but corrective footwear can be utilised for painful PV. Orthopaedic referral is needed if conservative treatment is not sufficient. It is important to distinguish between flexible and rigid PV, since rigid PV can be a sign of underlying pathologies and needs referral to orthopaedic surgeons. Further studies are needed to investigate for predictive factors to develop painful PV.
Topics: Child, Preschool; Humans; Conservative Treatment; Flatfoot; Osteotomy; Pain
PubMed: 36636936
DOI: No ID Found -
The Physician and Sportsmedicine Sep 2019: Flexibility and strength are compromised in pronated feet, which could in turn lead to alteration of the dynamic balance and muscle activity in the lower extremities.... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of selective strengthening of tibialis posterior and stretching of iliopsoas on navicular drop, dynamic balance, and lower limb muscle activity in pronated feet: A randomized clinical trial.
: Flexibility and strength are compromised in pronated feet, which could in turn lead to alteration of the dynamic balance and muscle activity in the lower extremities. This study aimed to analyze the effects of selective tibialis posterior strengthening and iliopsoas stretching on navicular drop, dynamic balance, and lower limb muscle activity in young adults with pronated feet. : Twenty-eight participants with pronated feet were randomly assigned to either the stretching and strengthening group ( = 14) or the conventional exercise group ( = 14). The stretching and strengthening group performed tibialis posterior strengthening exercises and iliopsoas stretching three times a week for 6 weeks in addition to the conventional towel curl exercises. The conventional exercise group performed towel curl exercises only. Navicular drop, dynamic balance, and lower limb muscle activity were assessed at baseline and post-intervention. A mixed model analysis of variance was performed to test the study hypothesis. : Significant group effects for the activity of tibialis anterior ( = 0.003) and abductor hallucis muscle ( = 0.010), as well as for the posterolateral ( = 0.036) and composite reach scores ( = 0.018), were detected. Significant group × time interactions were observed for naviculardrop ( < 0.001), all dynamic balance components ( < 0.001), and the activity of tibialis anterior ( < 0.001) and abductor hallucis ( < 0.001). : This study demonstrated that inclusion of selective tibialis posterior strengthening and iliopsoas stretching in addition to the conventional towel curl exercise program could improve important clinical outcomes, such as navicular drop, muscle activity, and dynamic balance in flatfeet.
Topics: Adult; Electromyography; Exercise Therapy; Female; Flatfoot; Foot; Hip; Humans; Male; Muscle, Skeletal; Postural Balance; Tarsal Bones; Young Adult
PubMed: 30517043
DOI: 10.1080/00913847.2018.1553466 -
Skeletal Radiology Nov 2021Flatfoot is commonly encountered in the paediatric population and describes a spectrum of clinical and radiological presentations which encompass both normally... (Review)
Review
Flatfoot is commonly encountered in the paediatric population and describes a spectrum of clinical and radiological presentations which encompass both normally developing and pathological feet. Flatfoot can be categorised as flexible or rigid, a distinction which has important implications when considering the potential underlying aetiology and treatment options, and therefore imaging is an important component of the diagnostic workup. Weight-bearing plain radiographs are established initial investigations, although the significance of a number of the commonly derived quantitative parameters in children remains unclear. CT and MRI are important additional imaging modalities reserved for the investigation of symptomatic cases or those in which an underlying structural abnormality is suspected, rigid flatfoot commonly falling into one of these two categories. We review and illustrate the multimodality imaging of the paediatric flatfoot, with reference to both qualitative and quantitative radiographic assessment and cross-sectional imaging appearances.
Topics: Child; Flatfoot; Foot; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Radiography
PubMed: 34002241
DOI: 10.1007/s00256-021-03806-8 -
Foot and Ankle Clinics Dec 2018The crucial role of the spring ligament complex within the pathologic process that leads to flatfoot deformity has evolved recently. There has been improvement in the... (Review)
Review
The crucial role of the spring ligament complex within the pathologic process that leads to flatfoot deformity has evolved recently. There has been improvement in the anatomic knowledge of the spring ligament and understanding of its complex relationship to the deltoid complex and outstanding advances in biomechanics concepts related to the spring ligament. Optimization of flatfoot treatment strategies are focused on a renewed interest in the spring ligament and medial soft tissue reconstruction in concert with bony correction to obtain an adequate reduction of the talonavicular deformity and restoration of the medial longitudinal arch.
Topics: Flatfoot; Foot Joints; Humans; Joint Instability; Ligaments, Articular
PubMed: 30414659
DOI: 10.1016/j.fcl.2018.07.012 -
Foot and Ankle Clinics Sep 2018One of the most common orthopedic problems in the authors' practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of... (Review)
Review
One of the most common orthopedic problems in the authors' practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of consensus about the type of surgical treatment that is best recommended in a specific patient. Keeping in mind that medial soft tissue reconstruction alone has not proved enough as an isolated procedure and that osteotomies and arthrodesis are considered more invasive surgery, arthroereisis is a quick, easy, and reproducible technique that seems to have good results without major complications in the correct patient. Indications, biomechanical principles, and technique are described in this article.
Topics: Arthroplasty; Arthroplasty, Replacement; Flatfoot; Humans; Minimally Invasive Surgical Procedures
PubMed: 30097082
DOI: 10.1016/j.fcl.2018.04.010 -
Foot and Ankle Clinics Jun 2020Stage 4 flatfoot represents only a small proportion of flatfoot cases and is likely to become even rarer. The evidence base to guide treatment is limited to case series... (Review)
Review
Stage 4 flatfoot represents only a small proportion of flatfoot cases and is likely to become even rarer. The evidence base to guide treatment is limited to case series and expert opinion. Therefore, a pragmatic approach to treatment must be taken. Low-demand individuals may manage well with conservative treatment. Surgical management is complex, likely to require staging, and has a significant complication profile. Patients should be fully informed and understanding of this. First principles of surgery should be followed, including restoring hindfoot and ankle joint alignment, appropriate soft tissue balancing, and optimizing function by limiting arthrodeses and subsequent stiffness.
Topics: Flatfoot; Humans; Orthopedic Procedures; Orthotic Devices; Posterior Tibial Tendon Dysfunction
PubMed: 32381314
DOI: 10.1016/j.fcl.2020.02.002 -
MMW Fortschritte Der Medizin Apr 2023
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MMW Fortschritte Der Medizin Apr 2023
Review
Topics: Humans; Adult; Flatfoot; Biomechanical Phenomena
PubMed: 37016237
DOI: 10.1007/s15006-023-2487-x -
BMJ (Clinical Research Ed.) Feb 2020
Topics: Diagnosis, Differential; Female; Flatfoot; Foot Deformities, Acquired; Foot Orthoses; Humans; Middle Aged; Pain; Physical Therapy Modalities
PubMed: 32094144
DOI: 10.1136/bmj.m295 -
Orthopaedics & Traumatology, Surgery &... Feb 2022Calcaneal osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot deformity. It has static, architectural and dynamic effects,... (Review)
Review
Calcaneal osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot deformity. It has static, architectural and dynamic effects, reorienting the tuberosity action point of the digastric muscle formation of the sural triceps and plantar aponeurosis. Calcaneal osteotomies vary in location, form and displacement, but can be categorized as tuberosity osteotomy, acting on talar position, and cervical osteotomy, acting on Chopart joint-line orientation. We here describe the 3 main calcaneal osteotomies we use for hindfoot deformity: talar varus/valgus, valgus flatfoot, and midfoot abductus/adductus. In each case, we describe our technique, resulting from our responses to the difficulties we have had to deal with: medializing osteotomy: performed percutaneously to limit skin complications, and easily associated to cervical calcaneal osteotomy to manage valgus flatfoot; Hintermann cervical adduction osteotomy: providing excellent angular correction, while conserving a medial cortical hinge; lateralizingosteotomy: performed on a medial approach, to enhance translation capacity and prevent the acute tarsal tunnel syndrome with which we have been otherwise confronted. Correcting foot deformities involves complex, multi-dimensional, multi-tissue surgery that is risky as it concerns a segment with terminal vascularization. The present three techniques need to be mastered, as they are usually associated to other tendon and/or ligament reconstruction procedures, and tourniquet time is limited. LEVEL OF EVIDENCE: V; expert opinion.
Topics: Calcaneus; Flatfoot; Foot; Humans; Osteotomy; Plastic Surgery Procedures; Tendons
PubMed: 34687951
DOI: 10.1016/j.otsr.2021.103121