eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Pes Planus: Follow-up

Author: Matthew Buchanan, MD, Attending Surgeon, Orthopedic Foot and Ankle Surgery, Orthopaedic Foot and Ankle Center of Washington, DC
Coauthor(s): Gregory C Berlet, MD, FRCS(C), Clinical Assistant Professor of Orthopedics, Chief of Foot and Ankle Surgery, Department of Orthopedic Surgery, Ohio State University College of Medicine and Public Health; Abdi Raissi, MD, Staff Physician, Desert Orthopaedic Center
Contributor Information and Disclosures

Updated: Feb 27, 2009

Outcome and Prognosis

Proper treatment of adult-acquired flatfoot deformity requires a comprehensive knowledge of foot biomechanics and astute clinical judgment. No single solution is appropriate for all patients and all degrees of dysfunction; rather, a continuum of treatment options must be considered to gain the best functional outcome for the individual patient.

The patients who are best suited for an optimal return to full function have mild changes of the dynamic structures but maintenance of the static restraints of the hindfoot. These patients are most tolerant of nonoperative treatment modalities and, if surgery is necessary, can reasonably expect a return to near-normal function if joint-sparing options are utilized.

Future and Controversies

posterior tibial tendon (PTT) insufficiency with different degrees of deformity at different joints in the foot is a challenge to manage. Considerable controversy remains about the appropriate treatment of all stages of PTT dysfunction. Comparison-outcome trials are needed to provide better data to evaluate the treatment options. To the authors' knowledge, to date, these trials have not been completed.

 
Acknowledgments

Thomas H Lee, MD, is gratefully acknowledged for the contributions made to this topic.



More on Pes Planus

Overview: Pes Planus
Workup: Pes Planus
Treatment: Pes Planus
Follow-up: Pes Planus
Multimedia: Pes Planus
References
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Keywords

pes planus, acquired flatfoot, adult-acquired flatfoot deformity, AAFD, progressive flatfoot deformity, posterior tibial tendon dysfunction, PTTD, posterior tibial tendon insufficiency, PTTI, fallen arches, posterior tibial tendon, PTT, talipes planus, flat foot, flatfoot, splayfoot, pes planovalgus, spring ligament complex, spring-ligament complex, too many toes sign, too-many-toes sign, plantar fasciitis, cri-du-chat, plantar heel pain

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Contributor Information and Disclosures

Author

Matthew Buchanan, MD, Attending Surgeon, Orthopedic Foot and Ankle Surgery, Orthopaedic Foot and Ankle Center of Washington, DC
Matthew Buchanan, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

Coauthor(s)

Gregory C Berlet, MD, FRCS(C), Clinical Assistant Professor of Orthopedics, Chief of Foot and Ankle Surgery, Department of Orthopedic Surgery, Ohio State University College of Medicine and Public Health
Gregory C Berlet, MD, FRCS(C) is a member of the following medical societies: American Medical Association, American Orthopaedic Foot and Ankle Society, Canadian Medical Association, Canadian Orthopaedic Association, College of Physicians and Surgeons of Ontario, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Abdi Raissi, MD, Staff Physician, Desert Orthopaedic Center
Disclosure: Nothing to disclose.

Medical Editor

James K DeOrio, MD, Director of Foot and Ankle Fellowship Program, Assistant Professor of Orthopedic Surgery, Orthopedic Surgery, St. Luke's Hospital, Jacksonville, Florida
James K DeOrio, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society, Florida Medical Association, and German Society of Neurology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri
Jason H Calhoun, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

 
 
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