Adult acquired flatfoot

Abstract

Acquired flatfoot in the adult population is a common reason for visits to the orthopedic surgeon. The function of the tibialis posterior is a vital component in the maintenance of the medial longitudinal arch. As such, any discussion of adult acquired flatfoot must focus on tibialis posterior dysfunction, although it is not the only etiology. The pathophysiology and progression of deformity are described by the classification system of Johnson and Strom, with later modification by Myerson. Diagnosis is made on clinical grounds by careful history, physical examination, and plain radiography. There are many options for conservative and operative treatment. Surgery is usually reserved for those who fail nonoperative management or demonstrate progression of deformity. The principles of surgical treatment focus on performing the least invasive procedure that will relieve pain and restore function. Soft tissue and joint-sparing procedures have gained recent popularity, but their long-term outcomes currently remain unknown.