Adult acquired flat foot was first described in the late 1960s as something that occurred after trauma, as a result of a tear to the tibial posterior tendon. However, by 1969 two doctors called Kettlekamp and Alexander described cases in which no trauma had taken place. They referred to the condition as "tibial posterior tendon dysfunction" and this became known as the most common type of adult acquired flat foot.
In more recent years as a result of on-going research, other dysfunctions have also been implicated as causes for flat foot, such as dysfunction of the spring ligament.
Other causes include:
Rheumatoid arthritis
This type of arthritis attacks the cartilage in the foot, leading to pain and flat feet. It is caused by auto-immune disease, where the body’s immune system attacks its own tissues.
Diabetes
Having diabetes can cause nerve damage and affect the feeling in your feet and cause arch collapse. Bones can also fracture but some patients may not feel any pain due to the nerve damage.
Obesity and/or hypertension (high blood pressure)
This increases your risk of tendon damage and resulting flat foot.
Symptoms
Some symptoms of adult acquired flat foot are pain along the inside of the foot and ankle, pain that increases with activity, and difficulty walking for long periods of time.
You may experience difficulty standing, pain on the outside of the ankle, and bony bumps on the top of the foot and inside the foot.
You may also have numbness and tingling of the feet and toes (may result from large bone spurs putting pressure on nerves), swelling, a large bump on the sole of the foot and/or an ulcer (in diabetic patients).
Diabetic patients should wear a properly fitting diabetic shoe wear to prevent these complications from happening.
Treatment
Patients can be treated non-surgically with in-shoe devices and braces to hold their feet in the correct position. This can reduce pain and damage and assist with walking.
Physical therapy is also given to improve muscle strength and help prevent injury to the foot.
Surgery can be performed if the patient doesn’t find any relief.
A new type of surgery has been developed in which surgeons can re-construct the flat foot deformity and also the deltoid ligament using a tendon called the peroneus longus.
A person is able to function fully without use of the peroneus longus but they can also be taken from deceased donors if needed.
The new surgery was performed on four men and one woman. An improved alignment of the ankle was still evident nine years later, and all had good mobility 8 to 10 years after the surgery. None had developed arthritis.
Sources:
Adult Acquired Flat Foot, East Lancashire Foot and Ankle Hyperbook. Web. 21 June 2012.
http://foothyperbook.com/elective/aaff/aaffIntro.htm
Adult Acquired Flat Foot, Orthoinfo. Web. 21 June 2012.
http://orthoinfo.aaos.org/topic.cfm?topic=A00173
New Surgery Improves Outcomes for Severe Flat Foot Deformity, Science Daily. Web. 21 June 2012.
http://www.sciencedaily.com/releases/2010/07/100708081413.htm
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/ She is the mother of five children and practices natural childbirth, delayed cord clamping, full term breastfeeding and organic food diet.
Reviewed June 21, 2012
by Michele Blacksberg RN
Edited by Jody Smith