Patients with sensory neuropathy may result in Charcot arthropathy leading to midfoot collapse over time.
Other causes include injuries to soft tissues such as plantar fascia or spring ligament. It occurs more commonly in malunion of those fractures. Patients with trauma to the midfoot or hindfoot resulting in navicular, first metatarsal, calcaneal, or Lis-Franc ligament complex demonstrate an increased risk of developing pes planus. It can also occur in adults with congenital pes planus, especially those who participate in repetitive high impact sports such as basketball, running, or soccer. Posterior tibial tendon dysfunction is most common in females over the age of 40 with comorbidities, including diabetes and obesity. Acquired pes planus is most commonly occurs secondary to posterior tibial tendon dysfunction. The function of the posterior tibial tendon is to support the arch as well as inversion and plantarflexion of the foot. Obesity in children is significantly correlated with the tendency of the longitudinal arch to collapse in early childhood. There is a small percentage of children who fail to develop a normal arch by adulthood. Flexible pes planus describes a normal arch without bearing weight, which disappears with weight-bearing. Most cases of pes planus in children are flexible. Most children develop normal arches by age 5 or 6. Infants have a fat pad under the medial longitudinal arch, which serves to protect the arch during early childhood. Infants and young children are prone to absent arches secondary to ligamentous laxity and lack of neuromuscular control. Pes planus can either be congenital or acquired. Dysfunction of the arch complex, specifically relating to flexible flat foot, can frequently be asymptomatic, but can alter the biomechanics of the lower limbs and lumbar spine causing an increased risk of pain and injury. It functions to dissipate the forces of weight-bearing and acts to store mechanical energy within the stretched elastic ligaments during the gait cycle. The arch serves as an adaptive and flexible base for the entire body. The talocalcaneal interosseous ligament, tibionavicular portion of the deltoid ligament, spring ligament, and medial talocalcaneal ligament assist in stabilizing the arch of the foot. The arch of the foot is a tough, elastic connection of ligaments, tendons, and fascia between the forefoot and the hindfoot. Pes planus commonly referred to as “flat feet,” is a relatively common foot deformity and is defined by the loss of the medial longitudinal arch of the foot where it contacts or nearly contacts the ground. Summarize interprofessional team strategies for improving care coordination and communication to advance the treatment of pes planus and optimize patient outcomes.
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