CURRENT OPINIONS AND BIOMECHANICAL CONCEPTS IN THE TREATMENT OF FLEXIBLE FLAT FOOT

The flat foot is a distinct medical condition within the deformities of foot and it has a prevalence of about 27% in adults. In children, the prevalence is variable depending on the age. Although the condition is predominantly idiopathic, in children it may be related to neuromuscular disease(s) and other disorders, including tarsal coalition and accessory navicular syndrome. Basically, similar principles of correction apply to both the treatment of flexible flat feet in children and to the treatment of flat feet in adults, except for the case that, in children, there is no rupture of the posterior tibial tendon, where rigid deformities are less common.The flat foot is a postural condition also known as a pes planus or fallen arches. It is a consequence of the collapse of the medial arch of foot. The major function of the longitudinal arch is to help propelling the foot and to attenuate the shock while being in orthostatic posture and while walking. A detrimental effect of the flat foot is that it decreases the capacity to absorb the shock due to the collapse of the longitudinal arch.Flat foot is a consequence of the laxity of the soft parts that support the longitudinal arch, the posterior tibia and intrinsic muscles, the plantar and tarsal fascia, as well as the deltoid and calcaneonavicular ligaments.Among these, the posterior tibia is considered the main dynamic structural support of the arch. When other supporting tissues are loosened, an even greater load is placed on the posterior tibia to maintain the arch. Muscle fatigue and dysfunction is a common cause of flat foot and it may lead to other problems, such as stress fractures and plantar fasciitis.This deformity may occur early as a congenital deformity, but it may occur as you grow older, gain weight, and decrease in the strength of the soft tissues that support the arch.The flat foot may not always lead to other pelvic limb deformities. Many people have flat foot and claim no symptoms.