A Survey of Eight Hundred and Eighty-Two Feet in Normal Children and Adults. Supple K, Hanft J, Murphy B, Janecki C, Kogler G. Acquired Flat Foot Deformity: Postoperative Imaging. Dimmick S, Chhabra A, Grujic L, Linklater J. Radiographic Diagnosis of Tarsal Coalition. in the acquired form, the midtarsal joint is altered by a forward-jutting talus in the congenital form the talus is medially displaced, but the midtalar line appears normal (i.e., it is pseudonormal).in the acquired form, the calcaneus is downwards-concave in the congenital form it is downwards-convex or flat.in the acquired form, the calcaneal pitch is at least 10° in congenital pes planus it is less.
talonavicular undercoverage or subluxation (where the talonavicular coverage angle is >7°)Īcquired pes planus (i.e., foot collapse), can be distinguished from congenital pes planus by carefully assessing the calcaneus and midtarsal joint: 6.hindfoot valgus (where the talocalcaneal angle is >35°).disruption of the cyma line: appears as a "lazy S-shape" of the talonavicular and calcaneocuboid joints on both AP and lateral views it is disrupted owing to anterior shift of the talonavicular joint 8.sagging at the talonavicular or naviculocuneiform joints.loss of the normal straight-line relationship with Meary's angle >4° convex downwards.Pes planus, in contradistinction, will show 7: In normal feet, the relationship between the talus and the 1 st metatarsal results in a straight line being formed along their axes (i.e. If the patient is unable to stand or weight-bear, a simulated weight-bearing radiograph should be obtained. The longitudinal arch of the foot must be assessed on a weight-bearing lateral foot radiograph. There is some evidence to suggest that flat feet protect against stress fractures ref. There are several conditions associated with pes planus 1-2:
These deformities are usually flexible, which means that on non-weight-bearing views, the alignment of the plantar arch normalizes. Pes planus results from loss of the medial longitudinal arch and can be either rigid or flexible. Within the first decade, there is spontaneous development of a strong arch in most people 7. In the pediatric population, the degree of ligamentous laxity of the foot results in relative pes planus that resolves over time 5.
Approximately 10% (range 7-15%) of the population with developmental flatfoot go on to develop symptoms requiring medical attention 7. Pes planus may occur in up to 20% of the adult population, although the majority of patients are asymptomatic and require no treatment. Pes planus is also known as flatfoot, planovalgus foot or fallen arches 7.
0 kommentar(er)
