[A painful collapse: the flat foot management].

Area of Science:

• Orthopedics and Sports Medicine
• Podiatry
• Biomechanics

Context:

• Flatfoot (pes planus) is a common foot deformity characterized by the collapse of the medial arch.
• Historically, treatment focused on posterior tibial tendon dysfunction, but the understanding has evolved.
• Modern understanding defines flatfoot as a complex, three-dimensional deformity involving multiple anatomical structures.

Purpose:

• To describe the evolving conceptualization of flatfoot deformity.
• To outline the key anatomical alterations and clinical signs associated with symptomatic flatfoot.
• To guide the therapeutic approach based on deformity severity and radiological findings.

Summary:

• Flatfoot involves hindfoot valgus, forefoot abduction/varus, and ankle instability.
• Clinical assessment of deformity rigidity and weight-bearing X-rays are crucial for treatment planning.
• Mild cases are managed with conservative treatments like plantar supports and rigid orthoses.
• Severe, rigid deformities may require surgical intervention, including bone, ligament, tendon, or prosthetic procedures.

Impact:

• Provides a comprehensive overview of current flatfoot management strategies.
• Highlights the shift towards a three-dimensional understanding of the deformity.
• Aids clinicians in selecting appropriate treatments for varying degrees of flatfoot severity.