Surgical outcome in acquired flat feet stage II

Abstract

Objective: The insufficiency of the posterior tibial tendon is one of the major causes of flat feet in adults. A lot is known about its evolution, but its treatment is still questioned, especially in stage II. Aiming at finding the best treatment, we analyzed the clinical results (subjective satisfaction, test on the tip of the feet, supinator strength and the American Orthopaedic Foot and Ankle Society scale pre and post-surgery) and radiographic results (first angle talometatarsal, talocalcaneal angle, height of the medial cuneiform and coverage of the talus) in 13 patients (13 feet) that presented flat feet acquired at an adult stage II. Methods: Patients were treated from January 2001 to August 2008 to fill out the necessary follow-up. There were 11 females; age average was 63.4 years old. Patients with refractory pain from the conservative treatment, age over 50 years old, weakness of the posterior tibia tendon and flat feet at the beginning of adult age were included. Patients who presented with diabetes, infection, inflammatory arthropathies, trauma consequences, tarsal bar, neuroarthropathy and arthrosis were excluded. Results: Out of 13 patients, 9 were considered much better (69.3%), 2 better (15.3%) and 2 worst (15.3%) than before the surgery. The average time for follow-up was of 49 moths (12-94 months). American Orthopaedic Foot and Ankle Society scale for post-surgery was an average of 24 (8-54) and the post-surgery was of 79.3 (28-100). Conclusion: Recovery occurs in the medium term and radiographic findings do not correlate with clinical outcomes.