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Review
. 2020 Nov;49(11):954-961.
doi: 10.1007/s00132-020-03991-9.

[Adult acquired flatfoot deformity-operative management for the early stages of flexible deformities]

[Article in German]
Dariusch Arbab  1 , Christian Lüring  2 , Manuel Mutschler  3 , Natalia Gutteck  4 , Bertil Bouillon  5
Affiliations
Review

[Adult acquired flatfoot deformity-operative management for the early stages of flexible deformities]

[Article in German]
Dariusch Arbab et al. Orthopade. 2020 Nov.

Abstract
in English, German

Flexible adult acquired flatfoot deformity includes a wide spectrum of fore- and hindfoot pathologies and remains a complex clinical challenge. Clinical history, inspection and accurate physical examination are paramount for diagnosis. Early stages of flexible adult acquired flatfoot deformity present with increased hindfoot valgus and medial arch collapse. Operative management typically consists of an open medializing calcaneal osteotomy and an augmentation of the insufficient posterior tibial muscle using a flexor digitorum longus tendon transfer. New surgical techniques and a deeper understanding of pathophysiology may change traditional treatment pathways.

Der erworbene, flexible Plattfuß des Erwachsenen stellt aufgrund verschiedener Fehlstellungen des Vor- und Rückfußes und seiner komplexen Pathobiomechanik weiterhin eine Herausforderung dar. Die Diagnose wird durch die gründliche Anamnese, Inspektion und körperliche Untersuchung gestellt. Im frühen Stadium der flexiblen Plattfußdeformität liegen definitionsgemäß ein vermehrter Fersenvalgus und eine Abflachung der medialen Längswölbung vor. Die operativen Therapieoptionen beinhalten standardmäßig eine offene medialisierende Kalkaneusosteotomie und die Augmentation des M. tibialis posterior mittels Flexor-digitorum-longus-Sehnentransfer. Neue Operationstechniken und ein tieferes Verständnis für die Pathobiomechanik stellen jedoch etablierte Methoden zunehmend infrage und zeigen neue Behandlungswege auf.

Keywords: Calcaneus; Osteotomy; Pes planus; Posterior tibial tendon insufficiency; Tendon transfer.

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References

Literatur

Verwendete Literatur
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Weiterführende Literatur
    1. Walther M (2017) Degeneration der Tibialis posterior Sehne. Bewährtes und Neues. Unfallchirurg 120:1031–1037 - DOI - PubMed

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