Acquired Flatfoot Deformity

Acquired adult flatfoot deformity (AAFD) is a condition that results in the gradual flattening of the arch of the foot. While AAFD can be caused by a number of factors, it most commonly results from dysfunction of the posterior tibialis tendon, the main tendon supporting the arch in the foot. Other causes can include laceration of the tendon, fractures or dislocation, tarsal coalition, neurologic weakness, and iatrogenic causes. Risk factors can include obesity, hypertension, previous trauma or surgery involving the foot, and treatment with steroids.

Patients with posterior tibialis tendon dysfunction may initially experience pain and swelling of the ankle and midfoot when bearing weight. As the condition progresses, patients may notice fallen arches and a tendency to walk on the inner border of the foot.

Treatments Available

Many adults with acquired flatfoot deformity do not experience pain or difficulties when walking, and so do not require specialized treatment. For those who do suffer from pain or problems wearing shoes and bearing weight, nonsurgical and surgical treatment approaches can be taken. This includes:

  • Nonsteroidal anti-inflammatory medications
  • Rest and protection of sore tendon, including immobilization in a boot or firm arch support to alleviate tendon pressure.
  • Physical therapy to strengthen the tendon, and ultrasound therapy, heat, and ice to control swelling and pain.
  • Cortisone / steroid injections in the posterior tibialis tendon is not advised due to risks of rupture.

Surgical management of acquired flatfoot deformity may be an option for patients who experience pain despite months of nonsurgical treatment. Surgery to address flatfoot consists of repairing the tendon through a tendon transfer to the posterior tibialis tendon, as well as manipulation and reshaping of the bones in the foot. Research indicates that tendon transfers without bone reshaping have limited success in treating flatfoot.

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Torrance Memorial Physician Network provides patient-centered care and treatment tailored to your unique needs and goals. If you have questions about acquired flatfoot deformity, treatment options, and how our board-certified physicians can help, call today to request an appointment.