Acquired adult flatfoot is a three-dimensional deformation, which consists of hindfoot valgus, collapse of the longitudinal arch of the foot and adduction of the forefoot.
The aim of the work is to present problems related to etiology, biomechanics, clinical diagnostics and treatment principles of acquired flatfoot.
The most common cause in adults is the dysfunction of the tibialis posterior muscle, leading to the lack of blocking of the transverse tarsal joint during heel elevation. Loading the unblocked joints consequently leads to ligament failure. The clinical image is dominated by pain in the foot and tibiotarsal joint.
The physical examination of the flat feet consists of: inspection, palpation, motion range assessment and dynamic force assessment. The comparable attention should be paid to the height of the foot arch, the occurrence of “too many toes” sign, evaluate the heel- rise test and correction of the flatfoot, exclude Achilles tendon contracture. The diagnosis also uses imaging tests.
In elastic deformations with symptoms of posterior tibial tendonitis, non-steroidal anti-inflammatory drugs, short-term immobilization, orthotics stabilizing the medial arch of the foot are used. In rehabilitation, active exercises of the shin muscles and the feet, especially the eccentric exercises of the posterior tibial muscle, are intentional.
The physiotherapy and balneotherapy treatments, in particular hydrotherapy, electrotherapy and laser therapy, are used as a support. In advanced lesions, surgical treatment may be necessary, including plastic surgery of soft tissues, tendons, as well as osteotomy procedures.
Posterior tibial slope: the fingerprint of the tibial bone