Treatment of Flatfoot Deformity

Dong-Oh Lee; Hong-Geun Jung

doi:10.14193/jkfas.2016.20.1.6

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Lee and Jung: Treatment of Flatfoot Deformity

Review Article

J Korean Foot Ankle Soc 2016;20(1):6-11.

Published online: 10 March 2016

DOI: https://doi.org/10.14193/jkfas.2016.20.1.6

Treatment of Flatfoot Deformity

Dong-Oh Lee^*, Hong-Geun Jung

Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea

^*Department of Orthopedic Surgery, Myongji Hospital, Goyang, Korea

Corresponding Author: Hong-Geun Jung Department of Orthopedic Surgery, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: 82-2-2030-7609, Fax: 82-2-2030-7369, E-mail: jungfoot@hanmail.net

Received 8 February 2016 Revised 17 February 2016 Accepted 17 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Flatfoot deformity, defined as loss of medial longitudinal arch, sometimes involves symptoms such as medial arch pain or Achilles tendon tightening, etc. Whether the etiology of deformity is congenital or acquired, i.e., posterior tibial tendon dysfunction, symptoms are largely resolved with conservative treatment including medication, orthoses, and activity modification. Surgery should be considered in cases of failure of conservative treatment and clinicians can select an appropriate technique among many surgical options including calcaneal osteotomy or flexor digitorum longus tendon transfer. Principles of corrective surgery include the recovery of alignment and the preservation of joint motion.

Keywords: Flatfoot, Conservative treatment, Surgical procedure

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Figure 1.

Flexor digitorum longus (FDL) transfer procedure. (A) Photograph shows isolated FDL tendon. Drilling at the navicular tuberosity (B), then tenodesis is performed Fig. 1C and D.

Figure 2.

Fluoroscopy shows medial sliding calcaneal osteotomy at sagittal view (A) and axial view (B).

Figure 3.

(A) Interpositional allo-bone graft was performed at calcaneal anterior process. (B) Postoperative lateral standing radiograph shows elevated calcaneal pitch after lateral column lengthening.

Figure 4.

Preoperative flatfoot deformity (A) was improved after subtalar arthroereisis (B).

Figure 5.

Multiple arthritic change with severe deformity (A) usually requires triple arthrodesis procedure (B).

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