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Chaiphrom, Nusorn, Chamnanni Rungprai i Nantaphon Chuvetsereporn. "Prevalence and effect of flatfoot among army privates". Journal of Southeast Asian Medical Research 1, nr 2 (26.12.2017): 70–73. http://dx.doi.org/10.55374/jseamed.v1i2.29.
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Background: Specific populations require strenuous activities such as soldiers, and flatfoot deformity can cause significant problems during training or operations. Prevalence of this deformity among Thai Army privates is limited and underestimated due to improper screening techniques. We would like to report the prevalence of flatfoot deformity using a new standardized device and compare performances of army privates between normal foot and flatfoot deformity Study design: The study employed a cross-sectional design Materials and Methods: A prospective study of 490 army privates in the King’s Guard, 2nd Cavalry Division, between June 2015 and November 2015 was conducted. Footprints were collected from all participant using a Harris Mat imprinter and the shape of their feet was recorded based on arch height. The Stahili index >0.77 (NY index) and arch height less than 6 mm were used as cut-off point values to diagnose flatfoot deformity. Additionally, military training performance (running 2 km) was evaluated using validated functional outcome (VAS-FA) and compared between normal arch and flatfoot deformity groups. Results: The prevalence of flatfoot deformity determined using footprints was 52.5% (233 participants: 111 of 233 participants were unilateral (47.6%) and 146 of 233 participants (52.3%) were bilateral flatfeet). The physical training revealed significant differences when compared between bilateral flatfeet and normal arch groups (p= 0.038) and bilateral flatfeet unilateral flatfoot groups (p= 0.009) BMI, VAS score and flatfoot deformity significantly affected the performances of their training (p= 0.03, 0.02, and 0.03 for BMI, VAS score and flatfoot deformity, respectively.) Conclusion: The prevalence of flatfeet deformity among army privates from this study was higher than relates studies. Bilateral flatfeet deformity had a significant effect on physical training. Although many factors affect training performance, BMI, VAS score and flatfoot deformity significantly affected the military training program.
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Lee, Woo-Chun, Chihoon Ahn, Ji-Beom Kim i Mu Hyun Kim. "Dynamic Pedobarography Shows Pain Avoidance Gait of Symptomatic Severe Flatfoot Patient". Foot & Ankle Orthopaedics 3, nr 2 (19.04.2018): 2473011418S0001. http://dx.doi.org/10.1177/2473011418s00010.
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Category: Basic Sciences/Biologics, Midfoot/Forefoot Introduction/Purpose: In the flatfoot patients, collapsed medial longitudinal arch during gait induced pain and it results decreased center of progression excursion index(CPEI) in dynamic pedobarography. Although the CPEI decreased is pathologic gait of flatfoot patients, range of the CPEIs is wide even in similar severity of flatfoot patients. We hypothesized that some flatfoot patients inverted forefoot or elevated first metatarsal head during gait for avoiding the pain from collapsed medial longitudinal arch, which resulted wide range of the CPEIs in flatfoot patients. The purposes of this study were to investigate the incidence of forefoot inversion and 1st metatarsal head elevation during gait in severe symptomatic flatfoot patients, and to confirm whether forefoot inversion and 1st metatarsal head elevation increases the CPEI, by using the dynamic pedobarography. Methods: We retrospectively evaluated patients who underwent surgery for flatfoot in our clinic from January, 2017 to May, 2017. Before surgery, all patients underwent plain weight-bearing radiographs and dynamic pedobarography by using in-shoe plantar pressure assessment system (Tekscan, Inc., South Boston, MA). Radiographic parameters, talonavicular coverage angle, Meary angle and moment arm, and the CPEI in dynamic pedobarogrpahy were measured. The forefoot inversion and the 1st metatarsal head elevation were defined when sum of 3rd-4th and 5th submetatarsal plantar pressure was higher than sum of 1st and 2nd submetatarsal plantar pressure, and when 2nd submetatarsal plantar pressure was higher than 1st submetatarsal plantar pressure, respectively. Correlations between the radiographic parameters and the CPEI were investigated. Incidence of the forefoot inversion and the 1st metatarsal head elevation was investigated. The CPEIs in flatfeet with forefoot inversion or 1st metatarsal head elevation were compared with those in flatfeet without these pain avoidance gait. Results: Twenty-eight flatfeet from 28 patients were included in the present study. The average age of patients was 42.3 years (range: 19-71). Means of the three radiographic parameters and the CPEI of the 28 flatfeet were listed at table.1. There was no significant correlation between the CPEI and the three radiographic parameters.(Table.2) The incidence of forefoot inversion and 1st metatarsal head elevation were 11%(3 feet), 54%(15 feet) respectively. The mean CPEI of the flatfeet with forefoot inversion or 1st metatarsal head elevation was 8(range: -10 – 18), and the mean CPEI of the flatfeet without these two compensations was 5 (range: -3 – 12). The CPEI in the flatfeet with the two compensations was significant larger than that of the flatfeet without the two compensations. (P=0.027) Conclusion: In the present study, forefoot inversion or 1st metatarsal head elevation were happened in 65% of symptomatic flatfoot patients. These two pain avoidance gait shifts weight-bearing load laterally, which decreases collapsing medial longitudinal arch and pain on the flatfoot. Because lateral shifting of weight-bearing load increases the CPEI, flatfoot patients with these two gaits showed high the CPEI. Therefore, the degree of the CPEIs are various even in similar severity of flatfoot and are not correlated with the severity of the flatfoot. Clinicians should consider these pain avoidance gait of flatfoot patients when they interpret a dynamic pedobarography of flatfoot.
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Vergillos Luna, Manuel, Adyb-Adrian Khal, Kara A. Milliken, Federico Solla i Virginie Rampal. "Pediatric Flatfoot: Is There a Need for Surgical Referral?" Journal of Clinical Medicine 12, nr 11 (1.06.2023): 3809. http://dx.doi.org/10.3390/jcm12113809.
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Pediatric foot deformities are a common finding, concerning up to 44% of preschool aged children. The absence of accepted international guidelines, as well as heterogeneity in definitions and measurements, makes management of pediatric flatfoot a challenge, and decisions surrounding specialized care referral confusing and biased. The objective of this narrative review is to provide guidance to primary care physicians treating these patients. A non-systematic review of the literature regarding the development, etiology, and clinical and radiographic assessment of flatfeet using the PubMed and Cochrane Library databases was performed. The exclusion criteria for the review were adult populations, papers detailing the outcome of a specific surgical procedure, and publications prior to 2001. The included articles showed great heterogeneity in definition and proposed management, which makes the study of pediatric flatfoot challenging. Flatfoot is a common finding in children under 10 years old, and should not be considered pathological unless stiffness or functional limitation are present. Surgical referral should be reserved to children with stiff or painful flatfoot, while simple observation is indicated for flexible, asymptomatic flatfeet.
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Ponnapula, Priya. "A Cross-disciplinary Approach to Understanding Flatfoot". Journal of the American Podiatric Medical Association 102, nr 4 (1.07.2012): 319–23. http://dx.doi.org/10.7547/1020319.
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As form follows function, pedal anatomy is embedded in a history of evolution. This literature review seeks to further the understanding of physiologic and pathologic flatfoot through cross-disciplinary research of expired and extant members of the Homininae subfamily. Archaeological, anthropological, paleontological, and ontogenetic evidence presents multiple biomechanical similarities and anatomical parallels between flatfooted hominins and humans. Recognizing an evolutionary pattern in flatfoot pathologic disorders enhances anticipation and effective treatment. (J Am Podiatr Med Assoc 102(4): 319–323, 2012)
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Cheney, Nicholas, Kyle Rockwell, Joseph Long, John Weis, Dylan Lewis, Timothy Law i Adam Carr. "Is a Flatfoot Associated with a Hallux Valgus Deformity?" Foot & Ankle Orthopaedics 2, nr 3 (1.09.2017): 2473011417S0001. http://dx.doi.org/10.1177/2473011417s000133.
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Category: Bunion Introduction/Purpose: An arch collapse model has been described for a multitude of foot and ankle problems that is based on a gastrocnemius equinus contracture producing a predictable collapse that has been described in five distinct phases. Previous studies have evaluated the presence of pes planovlagus in hallux valgus patients and concluded that this is a rare occurance. The Grand Rapids arch collapse model reviews adult foot pathology and believes there is a link between bunions and flatfeet. We wanted to evaluate patients with flatfeet and determine if they had an associated bunion deformity. Based upon the arch collapse model, there should be a significant number of flatfeet with an associated bunion deformity and our goal was to see if this proved to be true. Methods: We retrospectively reviewed the radiographs of patients diagnosed with a flatfoot based upon their ICD 9 and 10 codes in the senior author’s practice. For each patient, we used standard anteroposterior and lateral foot radiographs obtained on all new patients. Initially, we had 254 feet but had to exclude 93 feet due to inadequate radiographs, normal radiographs (normal meary’s angle and talonavicular coverage angle) or in patients who already had surgical procedures to the foot. This left 161 feet radiographs for review. We then measured the Meary’s angle on the lateral images and the talonavicular coverage angle, hallux valgus angle, intermetatarsal angle and sesamoid position on the anteroposterior radiographs. Results: Of the 161 feet that remained in the study, only 6 feet (3.7%) had no radiographic evidence of a bunion based upon sesamoid position, hallux valgus angle or the intermetatarsal angle. We did find a correlation with the severity of the flatfoot based upon the Meary’s angle and the talonavicular coverage angle with the severity of the bunion deformity defined by the sesamoid position, hallux valgus angle and the intermetatarsal angle. As the flatfoot got worse, the bunion did so as well. Conclusion: Our findings would seem to fit with the Grand Rapids arch collapse model. The hypermobility of the first ray that creates the bunion deformity then allows the arch to ultimately collapse. It also does not seem to contradict what has been found previously. Earlier studies showed a low association between patients with bunions who also had flatfeet. This would make sense as the deformity may not have progressed to the flatfoot yet. However, in our study the deformity has already progressed to a flatfoot and almost all have some radiographic evidence of a bunion.
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Payehdar, Somaieh, Hassan Saeedi, Amir Ahmadi, Mohammad Kamali, Maryam Mohammadi i Vahid Abdollah. "Comparing the immediate effects of UCBL and modified foot orthoses on postural sway in people with flexible flatfoot". Prosthetics and Orthotics International 40, nr 1 (18.06.2014): 117–22. http://dx.doi.org/10.1177/0309364614538091.
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Background: Different types of foot orthoses have been prescribed for patients with flatfoot. Results of several studies have shown that orthoses were able to change balance parameters in people with flatfoot. However, the possible effect of orthosis flexibility on balance has not yet been investigated. Objectives: The aim of the current study was to investigate the immediate effect of a rigid University of California Berkeley Laboratory (UCBL) foot orthosis, a modified foot orthosis, and a normal shoe on the postural sway of people with flexible flatfoot. Study design: Quasi-experimental. Methods: In all, 20 young adults with flatfoot (aged 23.5 ± 2.8 years) were invited to participate in this study. The Biodex Stability System was employed to perform standing balance tests under three testing conditions, namely, shoe only, UCBL, and modified foot orthosis. Total, medial–lateral, and anterior–posterior sway were evaluated for each condition. Results: The results of this study revealed no statistical difference in the medial–lateral and anterior–posterior stability indices between foot orthoses and shoed conditions. The overall stability index with the UCBL foot orthosis, however, was significantly lower than that with the modified foot orthosis. Conclusion: The UCBL foot orthosis was able to decrease total sway and improve balance in people with flexible flatfoot. Clinical relevance Results of previous studies have indicated that foot orthoses were able to affect the balance of people with flatfeet. However, the possible effects of flexible orthoses on balance have not been examined. The results of this study may provide new insight into material selection for those people with balance disorders.
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Shin, Hyucksoo, Dong Yeon Lee, Jae Hee Lee i Hyo Jeong Yoo. "Foot Gait Analysis In Old Female Patients with Acquired Adult Flatfoot". Foot & Ankle Orthopaedics 3, nr 3 (1.07.2018): 2473011418S0044. http://dx.doi.org/10.1177/2473011418s00445.
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Category: Midfoot/Forefoot Introduction/Purpose: Acquired adult flatfoot is thought to be caused by a loss of the dynamic and static supportive structure of the medial longitudinal arch. Current evaluation systems mostly rely on static measurements such as standing x-ray, CT and MRI. Recently, the gait analysis has been suggested to be a good tool for assessment of functional impairment. Although there are some previous investigations about gait of flatfoot, there was a limitation in control groups in terms of matching age and gender. The objective of this study was to find the effect of the acquired adult flatfoot on the segmental motion of the foot during gait by comparisons with age and gender controlled healthy adults. Methods: 20 symptomatic flatfeet (12 female patients, 51–80 years old) and 50 symptom-free normal feet (50 female participants, 60-69 years old) were included in this study. For radiographic examinations, meary angle, calcaneal pitch, talo-calcaneal angle, tibio-calcaneal angle was measured using standing lateral radiograph of the foot. And talonavicular coverage angle was measured using standing anteroposterior radiograph of the foot. For foot gait analysis, the temporal gait parameters such as cadence, speed, stride length, step width, step time were calculated. Segmental foot kinematics evaluated using a 3D MFM of a 15-marker set (Foot3D model). Inter-segmental angles (ISA) (hindfoot relative to tibia, forefoot to hindfoot, and hallux to forefoot) were calculated at each time points (100 time points for whole gait cycle). The ISAs (position) at specific phases of gait cycle, the change of ISA (motion) between phases and range of ISAs during the whole gait cycle were calculated and compared between groups. Results: Range of motion (ROM) of sagittal and transverse plane of hindfoot, and transverse plane of forefoot was lower in flatfoot group. ROM of coronal plane of hallux and sagittal plane of forefoot was higher in flatfoot group. There also are significantly different findings in flatfoot group such as more dorsiflexed position of forefoot segment, reduced forefoot abduction motion during terminal stance and loss of push off during preswing phase. In addition, the time of push off phase in flatfoot group occurred later than the control group. In other words, lag of stance phase occurred in flatfoot group (Figure 1). This tendency became even worse when the moderate group and the severe group were compared based on the -20 ° of meary angle. Conclusion: As shown in the gait analysis, the overall reduction in hindfoot ROM and the increase in forefoot ROM in the flatfoot group suggest a midfoot breakage, which shows a decrease in push off power and a lag in the stance phase. So, the results of this study suggest that altered segmental motion of the foot in acquired adult flatfoot patients with PTTD, which shows progressive deterioration according to severity. And we think that gait analysis can be used as an objective functional measurement system for evaluation of acquired adult flatfoot patients.
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Alabdulkareem, Abdulrahman I., Yasser I. Alkhalife, Abdulaziz M. Bayounis, Abdullah A. B. Shabib, Waleed A. Alrogy, Fares H. Al-Jahdali i Samir O. Alsayegh. "Bilateral talocalcaneal tarsal coalition with flatfeet treated with single-stage coalition resection and calcaneal lengthening osteotomy: A case report". Journal of Musculoskeletal Surgery and Research 6 (16.11.2022): 294–98. http://dx.doi.org/10.25259/jmsr_109_2022.
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A coalition is a bridge connecting osseous structures. Tarsal coalitions typically involve talocalcaneal and calcaneonavicular joints. As a result, patients might present with pain and/or rigid flatfoot deformity. We outline a case of bilateral middle facets talocalcaneal tarsal coalition with rigid flatfeet who was treated with resection combined with flatfoot reconstruction. the patient was an 11-year-old Saudi girl who had progressive bilateral flatfoot for which non-operative treatment failed. A single-stage middle facet talocalcaneal coalition resection with concomitant Evans calcaneal lengthening osteotomy and gastrocnemius recession was performed. Postoperatively, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle midfoot score was measured, and the patient had a score of 90/100. The outcome was satisfactory, and the other foot was operated on 6 months later, with the same procedure and outcome (AOFAS: 90/100). Six years of follow-up showed no recurrence and a satisfactory lifestyle with no activity limitation. We aimed to highlight the AOFAS score 6 years after resecting the coalitions while reconstructing the foot in a single-staged procedure.
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Panaet, Elena Adelina, Anna Zwierzchowska, Leonardo Alexandre Peyré-Tartaruga, Dan Iulian Alexe, Barbara Rosołek i Cristina Ioana Alexe. "Distribution of plantar pressures under static conditions, in various areas of the pediatric flatfoot in sensitive period of development – pilot study". Balneo and PRM Research Journal 14, Vol.14, no. 4 (20.12.2023): 607. http://dx.doi.org/10.12680/balneo.2023.607.
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Background: Flatfoot can alter the foot's ability to uniformly distribute the body weight on the plantar areas, possibly leading to biomechanical imbalances in the entire body. The purpose of the study was to determine the correlation between flatfoot and plantar pressure distribution in static conditions. (2) Material and methods: The study included a group of 23 children with flat feet (7.43±0.58 years old), which analyzed the correlations between the Foot Posture Index 6 (FPI 6) values and the plantar pressure distribution values. The instruments used were the Foot Posture Index 6 (FPI 6- a quantitative anatomical assessment under static conditions) and the Podata (device for recording images in real time of the body weight distribution on the plantar support). (3) Results: The statistical results have indicated significant correlations of strong intensity between the flat foot and the plantar pressure distribution in the midfoot, but also that the flatfoot significantly influences the values of the plantar pressure distribution in the midfoot. (4) Conclusion: The data showed that flatfeet influence the values of the plantar pressure distribution in the mid-area of the sole.
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Sun, Chengyi, Shuyuan Li, Mingjie Zhu, Fahim Choudhury, Mark S. Myerson i Ming-Zhu Zhang. "Three-Dimensional Measurements of the Sinus Tarsi and Tarsal Canal in Pediatric Flexible Flatfeet using Weightbearing CT Scans". Foot & Ankle Orthopaedics 7, nr 4 (październik 2022): 2473011421S0095. http://dx.doi.org/10.1177/2473011421s00959.
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Category: Hindfoot; Other Introduction/Purpose: When the hindfoot is in varus the tarsal canal becomes visible on a lateral Xray (XR) and has been referred to as a 'target sign'. However, the sinus tarsi (ST) and tarsal canal (TC) are not easily visible radiographically when associated with a flatfoot. The dimensions of both the ST and TC in normal and flatfeet are unknown, but if understood, could help with the design and implantation of an arthroereisis, a commonly performed procedure for correction of pediatric flatfoot deformity. Knowing the size of the TC will also reduce postoperative complications of arthroereisis such as stiffness, resulting from too large an implant. The aim of this study was to take three-dimensional (3D) measurements of the TC in pediatric flatfeet under weightbearing (WB) conditions. Methods: This was a prospective IRB approved study in pediatric patients with flexible flatfeet and asymptomatic children without flatfeet who were reviewed and analyzed. Using 3D computer-aided design (CAD) models from weightbearing CT (WBCT) scans, the following parameters were measured: the widest diameter of the posteromedial tarsal canal (WDPTC), the narrowest supero- inferior diameter of the tarsal canal (NSDTC), the length of the tarsal sinus, (LTS), the length of the tarsal canal (LTC) and the tarsal sinus and canal volume (TSCV). Correlations between patient age, Meary's angle, foot and ankle offset (FAO), and each of the above measured parameters were investigated. Both weight bearing and non-weight bearing CT scans were used for study to investigate the effect of bearing weight on the above-mentioned parameters. (Figures 1, 2). Results: Twenty-two children with flexible flatfeet (age range 9-14) and fourteen children with no foot deformity (age 9-15) were included for study. With the WBCT the TSCV decreased by 20% in comparison with non-weightbearing evaluation. The TSCV, the widest diameter of the anterolateral tarsal sinus (WDATS) and LTC decreased in flatfeet both under WB and NWB conditions compared with the control group. A positive linear correlation was found between the TSCV and patient age (r = 0.7307, P < 0.0001), while negative linear correlations were found between the TSCV and FAO (r = -0.5188, P < 0.0001) and Meary's angle (r = -0.3132, P = 0.0019). The tarsal sinus and tarsal canal volume significantly decreased in the flatfoot group during weight bearing, while the volume of the tarsal canal remained unchanged. Older age was not associated with either a wider tarsal canal or its orientation. Conclusion: Although the tarsal sinus and canal volume was positively associated with patient age, there was a negative correlation with both the FAO and Meary's angle. These findings may be very relevant in future study of the subtalar joint in both children and adults, and clearly have an implication for treatment of the pediatric flatfoot with arthroereisis.
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Cheng, Xiangyu, Zhiqin Deng, Weidong Song, Jianquan Liu i Wencui Li. "Effects of extraosseous talotarsal stabilization on the biomechanics of flexible flatfoot subtalar joints in children: a finite element study". International Journal of Research in Orthopaedics 8, nr 1 (24.12.2021): 5. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20214956.
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<p class="abstract"><strong>Background:</strong> Objective of the study was to generate an experimental foundation for the clinical application of extraosseous talotarsal stabilization (EOTTS) in treatment of flexible flatfeet in children by investigating the biomechanical characteristics of flexible flatfoot and the effects of EOTTS on hindfoot biomechanics.</p><p class="abstract"><strong>Methods:</strong> Three-dimensional finite element models of the foot and ankle complex were generated from computer tomography images of a volunteer’s left foot in three states: normal, flexible flatfoot, and post-EOTTS. After validation by X-ray, simulated loads were applied to the three models in a neutral position with both feet standing.</p><p class="abstract"><strong>Results:</strong> In the flexible flatfoot model, the contact stress on the subtalar joint increased and contact areas decreased, resulting in abnormal stress distribution compared to the normal model. However, following treatment of the foot with EOTTS, these parameters returned to close to normal. Subtalar joint instability leads to a flexible flat foot. Based on this study, it is proposed that EOTTS can restore the normal function of the subtalar joint in and is an effective treatment for flexible flatfoot in children. We and many clinical data studies provide evidence for sinus tarsi implants in pediatric patients. It is showed that the formation of flexible flatfoot is induced by subtalar joint instability.</p><p class="abstract"><strong>Conclusions:</strong> Because of the EOTTS provides the best biomechanical solution to subtalar joint instability, the EOTTS became an effective form for subtalar joint instability treatment.</p>
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Allam, Hatem H., Alsufiany Muhsen, Mosfer A. Al-walah, Abdulmajeed N. Alotaibi, Shayek S. Alotaibi i Lamiaa K. Elsayyad. "Effects of Plyometric Exercises versus Flatfoot Corrective Exercises on Postural Control and Foot Posture in Obese Children with a Flexible Flatfoot". Applied Bionics and Biomechanics 2021 (31.10.2021): 1–8. http://dx.doi.org/10.1155/2021/3635660.
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Background. Obesity contributes to the acquired flatfoot deformity which in turn impairs balance. Aim. The purpose of the current study was to compare the effect of plyometric exercises with flatfoot corrective exercises on balance, foot posture, and functional mobility in obese children with a flexible flatfoot. Methods. Forty-seven children participated in the study. Their age ranged from 7 to 11 years. Participants were randomly divided into 3 groups: experimental group I (EGI), experimental group II (EGII), and the control group (CG). The EGI received plyometric exercises and the EGII received corrective exercises, 2 sessions weekly for 10 weeks. The control group did not perform any planned physical activities. The Prokin system was used to assess balance, the timed up and go test (TUG) was used to assess functional mobility, and the navicular drop test (NDT) was used to assess foot posture. Results. EGI showed significant improvement in all balance parameters, foot posture, and TUG. EGII showed improvement in the ellipse area and perimeter in addition to foot posture and TUG. Conclusion. Plyometric exercises and foot correction exercises had a positive effect on foot posture, balance, and functional mobility in obese children with flatfeet.
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Ateeque, Adan, Sidrah Shabbir, Taha Nadeem, Hira Zubair i Zainab Khizar. "Prevalence of Flatfoot in School-Going Children, Lahore". Journal of Health and Rehabilitation Research 4, nr 2 (13.05.2024): 745–49. http://dx.doi.org/10.61919/jhrr.v4i2.898.
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Background: Flatfoot is characterized by a reduced medial longitudinal arch height and can be flexible or fixed, congenital, or acquired. It can influence physical activity and mood in children, and its prevalence varies widely among different populations. Objective: To determine the prevalence of flatfoot among school-going children aged 7-15 years in Lahore, Pakistan, and to assess its distribution across different age groups and genders. Methods: A cross-sectional study was conducted over six months at Dar-e-Arqam School, Westwood campus, Lahore. The sample size of 106 was calculated using the formula { n = Z^2 P(1-P) / d^2 } with a 16% expected prevalence, 7% precision, and Z value of 1.96. Non-probability sampling was used. Inclusion criteria were children aged 7-15 years of both genders, excluding those with fractures, congenital deformities, or a history of ankle sprain. Footprints were obtained using ink-impregnated pads, and the Chippaux-Smirak index (CSI) was used to diagnose and grade flatfoot. Data were analyzed using SPSS version 25, with descriptive statistics presented as frequencies and percentages. Results: The prevalence of flatfoot among the children was 40.6%, with 4 cases of unilateral flatfoot (3.8%) and 39 cases of bilateral flatfoot (36.7%). Normal arches were found in 62 children (58.5%), and 1 child (0.9%) had a high arch. Among those with flatfoot, 17 had grade 1 flatfoot (16.0%), 12 had grade 2 flatfoot (11.3%), and 14 had grade 3 flatfoot (13.2%). The highest prevalence of flatfoot was observed in the 7-9 years age group (23 cases), while the 13-15 years group had the highest number of normal arches (29 cases). There was no significant difference in the prevalence of flatfoot between genders. Conclusion: Flatfoot is relatively common among children in Lahore, with a prevalence of 40.6%. The condition's prevalence decreases with age, and no significant gender differences were observed. Further research should include a larger sample size, random sampling, and assessment of symptomatic aspects to enhance understanding.
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Evans, Angela Margaret. "The Flat-Footed Child—To Treat or Not to Treat". Journal of the American Podiatric Medical Association 98, nr 5 (1.09.2008): 386–93. http://dx.doi.org/10.7547/0980386.
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Background: This article addresses the treatment of pediatric flatfoot with foot orthoses and explores the existing knowledge from an evidence-based perspective. Methods: Studies investigating the use of foot orthoses for pediatric flatfoot were reviewed and ranked on the evidence hierarchy model according to research designs. Clinical guidelines and efficacy rating methods were also reviewed. Results: Three randomized controlled trials exist, and a systematic review and possible meta-analysis of these studies is in progress. The results of these studies, although not definitive for the use of orthoses for pediatric flatfoot, provide useful direction. Clinical guidelines for the management of flatfoot are a useful supplement for clinical decision making and have been enhanced. Conclusion: This article presents a pragmatic and evidence-based clinical care pathway for clinicians to use for pediatric flatfoot. It uses a simple “traffic light” framework to identify three subtypes of pediatric flatfoot. The clinician is advised to 1) treat symptomatic pediatric flatfoot, 2) monitor (or with discretion simply treat) asymptomatic nondevelopmental pediatric flatfoot, and 3) identify and advise asymptomatic developmental pediatric flatfoot. (Children with juvenile arthritis should receive customized foot orthoses.) This approach will dispel much of the contention surrounding the use of foot orthoses in children. (J Am Podiatr Med Assoc 98(5): 386–393, 2008)
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Staheli, LT. "Planovalgus foot deformity. Current status". Journal of the American Podiatric Medical Association 89, nr 2 (1.02.1999): 94–99. http://dx.doi.org/10.7547/87507315-89-2-94.
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Flatfoot may be classified as pathologic or physiologic. Pathologic flatfoot is often characterized by stiffness of the foot, causes disability, and requires treatment. Physiologic flatfoot is a normal variation; it causes no disability and tends to improve with time. Physiologic flatfoot is most common in individuals who are loose-jointed, are obese, or usually wore shoes during childhood. Treatment of children with physiologic flatfoot with orthoses or shoe modifications not only is ineffective but is uncomfortable and embarrassing for the child and is associated with lowered self-esteem in adult life.
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Tomaszewski, Ryszard, i Barbara Czasławska. "Paediatric flatfoot". Pediatria i Medycyna Rodzinna 16, nr 4 (31.12.2020): 368–72. http://dx.doi.org/10.15557/pimr.2020.0066.
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Paediatric flat feet are a serious therapeutic problem. During the child’s development, the foot is subject to the processes of anatomical and physiological modifications. In small children, the flat foot is a physiological variant. The assessment of the flat foot deformity is based on clinical examination, a podoscope examination and possibly radiological evaluation. Only from the age of about 3 years is it possible to consider the implementation of treatment, initially conservative with rehabilitation and possibly orthotics. Some patients require treatment with analgesics, anti-inflammatory drugs or physiotherapy due to the pain they experience, especially in the hindfoot. The lack of progress in conservative treatment requires consideration of surgical treatment, which must be individually adjusted. Arthroereisis, possibly combined with the elongation of the Achilles tendon, is the most commonly used treatment. In fixed deformities or congenital flat feet, corrective bone procedures are also performed, usually combined with soft tissue procedures.
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Brown, PB. "Rheumatoid flatfoot". Journal of the American Podiatric Medical Association 77, nr 1 (1.01.1987): 39–41. http://dx.doi.org/10.7547/87507315-77-1-39.
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Kim, Sung-Jae, Bong-Gun Lee i Il-Hoon Sung. "Adult flatfoot". Journal of the Korean Medical Association 57, nr 3 (2014): 243. http://dx.doi.org/10.5124/jkma.2014.57.3.243.
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Tareco, Jennifer M., Nancy H. Miller, Bruce A. MacWilliams i James D. Michelson. "Defining Flatfoot". Foot & Ankle International 20, nr 7 (lipiec 1999): 456–60. http://dx.doi.org/10.1177/107110079902000711.
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Dereymaeker, G. "The Flatfoot". Journal of Pediatric Orthopaedics B 1, nr 2 (1992): 170. http://dx.doi.org/10.1097/01202412-199201020-00030.
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Toullec, E. "Adult flatfoot". Orthopaedics & Traumatology: Surgery & Research 101, nr 1 (luty 2015): S11—S17. http://dx.doi.org/10.1016/j.otsr.2014.07.030.
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Ford, Samuel E., i Brian P. Scannell. "Pediatric Flatfoot". Foot and Ankle Clinics 22, nr 3 (wrzesień 2017): 643–56. http://dx.doi.org/10.1016/j.fcl.2017.04.008.
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Dare, David M., i Emily R. Dodwell. "Pediatric flatfoot". Current Opinion in Pediatrics 26, nr 1 (luty 2014): 93–100. http://dx.doi.org/10.1097/mop.0000000000000039.
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Moraleda, Luis, i Scott J. Mubarak. "Flexible Flatfoot". Journal of Pediatric Orthopaedics 31, nr 4 (czerwiec 2011): 421–28. http://dx.doi.org/10.1097/bpo.0b013e31821723ce.
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Lepow, Gary M., i Paul L. Valenza. "Flatfoot Overview". Clinics in Podiatric Medicine and Surgery 6, nr 3 (lipiec 1989): 477–89. http://dx.doi.org/10.1016/s0891-8422(23)00164-7.
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Zhai, JunNa, YuSheng Qiu i Jue Wang. "Does Flexible Flatfoot Require Treatment?: Plantar Pressure Effects of Wearing Over-the-Counter Insoles when Walking on a Level Surface and Up and Down Stairs in Adults with Flexible Flatfoot". Journal of the American Podiatric Medical Association 109, nr 4 (1.07.2019): 299–304. http://dx.doi.org/10.7547/16-103.
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Background: Orthotic insole is a popular physiotherapy for flatfoot. However, the effects and whether flexible flatfoot needs orthotic insole treatment are not clear, and how the plantar pressure changes while walking up and down stairs has not been studied. Therefore, this study observed the plantar pressures of different walking conditions to find the answers. Methods: Fifteen adults with flexible flatfoot and 15 adults with normal foot were examined while walking on a level surface and while walking up and down 10- and 20-cm stairs before treatment. The maximum force and the arch index were acquired with a force plate system. Participants with flexible flatfoot were instructed to wear the orthotic insoles for 3 months, and plantar pressures were measured again after treatment. The repeated measure was performed to analyze the data. Results: The maximum force and the arch index of flatfoot after treatment were significantly decreased under different walking conditions (P < .01). When walking down 10- and 20-cm stairs, the plantar data of normal foot and flatfoot were significantly increased (P < .05). Conclusions: Orthotic insoles could effectively improve the plantar pressure of flatfoot under different walking conditions. In addition, the arches of normal foot and flatfoot were obviously influenced when walking down stairs. It is, therefore, necessary to wear orthotic insoles for flexible flatfoot to prevent further deformation.
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Ramadhani, Alinda Nur, i Dea Linia Romadhoni. "Correlation between Flatfoot and Postural Balance in Children Aged 7-12 Years". FISIO MU: Physiotherapy Evidences 5, nr 2 (1.06.2024): 115–19. http://dx.doi.org/10.23917/fisiomu.v5i2.4259.
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Flatfoot is characterized by a decrease or flattening of the medial longitudinal arch of the foot. Flatfoot in children in general can cause certain clinical manifestations. In general, the condition of flatfoot can also occur physiologically, which is then referred to as flexible flatfoot. Normally the arch of the foot is formed in the first five years of life at an age range of 2-6 years. The arch of the foot plays an important role in absorbing ground reaction forces and supporting the body's weight during activities. The research design uses a cross-sectional study approach, which aims to find or study the relationship between flatfoot and balance in children aged 7-12 years. A total of 32 respondents aged 7-12 years who met the inclusion criteria were obtained through flatfoot examination using a wet footprint examination and balance examination using the Pediatric Balance Scale. The results of the Pearson Correlation Test show a significance value of 0.031 (p<0.05) between the variables flatfoot and balance, which means there is a relationship between the condition of flatfoot and balance in children aged 7-12 years. The correlation coefficient value is 0.383, which means that the strength of the relationship between the two variables is quite strong with the direction of the relationship being positive, which means that the higher the degree of flatfoot in the child, the lower the child's balance.
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Chiang, Chu-Yuan, Kuang-Wei Lin, Hui-Min Lee, Shun-Hwa Wei i Li-Wei Chou. "Effects of a 6-Minute Fast-Walking Protocol on Changes in Muscle Activity in Individuals with Flatfoot". Applied Sciences 12, nr 4 (20.02.2022): 2207. http://dx.doi.org/10.3390/app12042207.
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Flatfoot causes abnormal biomechanics in the lower extremity, resulting in discomfort and excessive burden on lower extremity muscles during functional tasks, and it potentially leads to associated syndromes in the lower extremity. The aim of this study was to investigate how a demanding, repetitive task affects the muscle strength, activities, and fatigue of the lower extremities during function tasks. Nineteen individuals with flexible flatfoot (10M9F, age: 24.74 ± 2.68 years) and fifteen non-flatfoot participants (6M9F, age: 24.47 ± 3.74) took part in this study. All participants performed maximal voluntary isometric contraction and functional tasks, including walking and single-leg standing tests before and immediately after a 6-min fast-walking protocol. A surface electromyography system was used to collect muscle activation data. Our results showed that, after 6 min of fast walking, peroneus longus activity increased only in the non-flatfoot group, and gastrocnemius activity increased in the flexible flatfoot group. In the flexible flatfoot group, greater recruitment in abductor halluces and greater fatigue in the tibialis anterior was observed. Individuals with flexible flatfoot showed altered muscle activation pattern after 6-min fast walking. These findings can provide an evidence-based explanation of associated syndromes in flatfoot populations and lead to potential intervention strategies in the future.
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Kenis, Vladimir Markovich, Yurii Alexeevich Lapkin, Ruslan Khalilovich Husainov i Andrei Viktorovich Sapogovskiy. "FLEXIBLE FLATFOOT IN CHILDREN (REVIEW)". Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 2, nr 2 (15.06.2014): 44–54. http://dx.doi.org/10.17816/ptors2244-54.
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Flatfoot is one of the most common musculoskeletal conditions in the daily practice of pediatric orthopedists. Despite of numerous studies, diagnostic criteria and principles of management remain controversial. Flexible flatfoot - is visually detectable decrease in the height of the longitudinal arch of the foot, which can be spontaneously corrected by active or passive motion and not accompanied by any contracture of foot and ankle. Flexible flatfoot is a benign condition which is normal for childhood. But this term is also used to describe a painful deformity with marked limitation of dorsiflection and “not physiological” flatfoot with unfavorable course and prognosis. Despite of the awareness of the parents, flexible flatfoot does not lead to pain and should not be followed by any kind of treatment. Special shoe modifications and orthopedic insoles are useless in the attempt to improve the foot, but can influence negatively psychological condition and self-estimation. Proper diagnosis of flexible flatfoot is necessary in order to avoid unnecessary treatment and to reveal patients with adverse prognosis and rigid forms of flatfoot which need special approach.
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Rajan, Lavan, Jaeyoung Kim, Tonya W. An, Rami Mizher, Syian Srikumar, Robert Fuller, Agnes D. Cororaton i Scott J. Ellis. "Impact of Asymptomatic Flatfoot on Clinical and Radiographic Outcomes of the Modified Lapidus Procedure in Patients with Hallux Valgus". Foot & Ankle Orthopaedics 7, nr 4 (październik 2022): 2473011421S0089. http://dx.doi.org/10.1177/2473011421s00890.
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Category: Midfoot/Forefoot; Bunion Introduction/Purpose: Patients presenting for hallux valgus frequently have an associated flatfoot deformity; however, many are not symptomatic. It is unclear if an asymptomatic flatfoot adversely affects outcomes of hallux valgus correction and should be simultaneously addressed. Prior studies have demonstrated that flatfoot alignment may not affect clinical outcomes after osteotomy procedures, yet no studies have investigated whether this also affects outcomes of the modified Lapidus procedure. The modified Lapidus achieves multiplanar correction through the tarsometatarsal (TMT) joint and stabilizes the medial column, which may be advantageous for flatfoot pathology. We aimed to investigate the relationship between asymptomatic flatfoot and patient-reported and radiographic outcomes after modified Lapidus for hallux valgus. We hypothesized that clinical and radiographic outcomes would be minimally affected by the presence of asymptomatic flatfoot. Methods: This was a retrospective cohort study including 142 patients who underwent the modified Lapidus procedure for hallux valgus at a single institution by 1 of 10 fellowship-trained foot and ankle surgeons. Sixty-one patients met radiographic criteria for asymptomatic flatfoot, which were 1) Meary's angle > 4 degrees, 2) calcaneal pitch < 18 degrees, and talonavicular coverage angle (TNCA) > 7 degrees. Patients with cavus deformity were excluded. Preoperative and minimum 1-year postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores between asymptomatic flatfoot and control groups were compared. Radiographic assessment involved comparisons of hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary's angle, talonavicular coverage angle (TNCA), and calcaneal pitch (CP). Preoperative and postoperative radiographic measures were compared to assess improvement in hallux valgus and flatfoot parameters. Results: Preoperatively, the flatfoot group had higher BMI (24.6 vs 22.6, P < .01). Both groups demonstrated preoperative to postoperative improvement in PROMIS physical function (P < .01), pain interference (P < .001), pain intensity (P < .001), and global physical health (P < .001). There were no preoperative or postoperative differences in PROMIS scores between groups (Table 1). Preoperatively, the flatfoot group had a higher IMA (15.2 vs 14.0 degrees, P = .02). Postoperatively, there were no differences in HVA or IMA between groups; however, the flatfoot group exhibited greater deformity in Meary's angle (8.3 vs -0.1 degrees), TNCA (19.2 vs 14.3 degrees), and CP (15.1 vs 19.6 degrees) (all P < .001). Both cohorts demonstrated significant preoperative to postoperative improvement in all radiographic parameters except for CP in the control group (P = .95). Conclusion: There were no significant postoperative differences in patient-reported outcomes of the modified Lapidus procedure between patients with and without asymptomatic flatfoot. Both groups achieved similar excellent radiographic correction of their hallux valgus deformity. Although radiographic flatfoot parameters did not improve to the level of control patients, patients experienced clinical improvement, without adverse outcomes or new flatfoot symptomatology. The modified Lapidus effectively corrects forefoot deformity and concurrently addresses instability at the first TMT joint, making it a valuable option for hallux valgus correction in patients with asymptomatic flatfoot.
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Rungprai, Chamnanni, i Parinya Maneeprasopchoke. "A Clinical Approach to Diagnose Flatfoot Deformity". Journal of Foot and Ankle Surgery (Asia Pacific) 8, nr 2 (2021): 48–54. http://dx.doi.org/10.5005/jp-journals-10040-1149.
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ABSTRACT Flatfoot is a complex disorder combining multiple static and dynamic deformities, associated with a collapsing medial longitudinal arch. The etiology of flatfoot is multifactorial and can be divided into two main groups; congenital and acquired groups. History, physical examination, and radiographs of the foot are used to establish and confirm the diagnosis. The staging system for flatfoot demonstrates the deformity and guides the appropriate treatment. This article will focus on etiologies, pathophysiology, and clinical approach to diagnose flatfoot deformity. How to cite this article: Rungprai C, Maneeprasopchoke P. A Clinical Approach to Diagnose Flatfoot Deformity. J Foot Ankle Surg (Asia Pacific) 2021;8(2):48–54.
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Sapogovskiy, Andrey V., i Aleksey E. Boyko. "Correlation between clinical and radiographic parameters of the feet in children with flatfoot". Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 8, nr 4 (9.01.2021): 407–16. http://dx.doi.org/10.17816/ptors41830.
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Background. Flatfoot in children is one of the most common reasons for visiting an orthopedic specialist. The main criteria in determining various types of flatfoot are clinical (severity of arch flattening, hindfoot valgus, and degree of the foot dorsiflexion) and radiographic (angular values calculated from lateral and anteroposterior radiographs). The primary assessment of the degree of flatfoot is based on the clinical criteria. Detection of changes in the foot shape is the reason for the radiographic assessment.
Aim. This study aimed to determine and analyze the relationship between clinical and radiological parameters of the feet in children with flatfoot.
Materials and methods. The study group included patients with flatfoot observed in the outpatient clinic of H. Turner National Medical Research Center within the period from 2018 to 2020. The study population consisted of 30 children (53 feet) with flexible flatfoot and 65 children (111 feet) with flatfoot and short Achilles tendon. The patients were 10 (8.3; 12) years old. Clinical parameters (valgus value, longitudinal arch angle, and degree of foot dorsiflexion) and radiographic data (Kites angle, Mearys angle, calcaneal pitch, talotibial angle, longitudinal arch angle, talonavicular coverage angle, and forefoot adduction angle) were analyzed. Statistical differences were determined between groups of patients with flexible flatfoot and patients flatfoot and short Achilles tendon, and correlations between the studied parameters were identified.
Results. Strong correlations were revealed in the following pairs of criteria: lateral Kites angle and lateral Mearys angle; talotibial angle and lateral Mearys angle; radiographic longitudinal arch angle and lateral Mearys angle; talotibial angle and lateral Kites angle; foot dorsiflexion and foot dorsiflexion with great toe extension; and radiographic longitudinal arch angle and calcaneal pitch. Only moderate and weak correlations were found between clinical and radiographic parameters of the feet.
Conclusion. The relationship between clinical and radiographic parameters of the feet in patients with flatfoot is characterized by a moderate and weak correlation. Results suggest that the assessment of the clinical parameters of the feet in this population does not provide complete information about the degree of flatfoot.
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Sapogovskiy, Andrey V., i Aleksey E. Boyko. "Correlation between clinical and radiographic parameters of the feet in children with flatfoot". Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 8, nr 4 (9.01.2021): 407–16. http://dx.doi.org/10.17816/ptors41830.
Pełny tekst źródłaStreszczenie:
Background. Flatfoot in children is one of the most common reasons for visiting an orthopedic specialist. The main criteria in determining various types of flatfoot are clinical (severity of arch flattening, hindfoot valgus, and degree of the foot dorsiflexion) and radiographic (angular values calculated from lateral and anteroposterior radiographs). The primary assessment of the degree of flatfoot is based on the clinical criteria. Detection of changes in the foot shape is the reason for the radiographic assessment.
Aim. This study aimed to determine and analyze the relationship between clinical and radiological parameters of the feet in children with flatfoot.
Materials and methods. The study group included patients with flatfoot observed in the outpatient clinic of H. Turner National Medical Research Center within the period from 2018 to 2020. The study population consisted of 30 children (53 feet) with flexible flatfoot and 65 children (111 feet) with flatfoot and short Achilles tendon. The patients were 10 (8.3; 12) years old. Clinical parameters (valgus value, longitudinal arch angle, and degree of foot dorsiflexion) and radiographic data (Kites angle, Mearys angle, calcaneal pitch, talotibial angle, longitudinal arch angle, talonavicular coverage angle, and forefoot adduction angle) were analyzed. Statistical differences were determined between groups of patients with flexible flatfoot and patients flatfoot and short Achilles tendon, and correlations between the studied parameters were identified.
Results. Strong correlations were revealed in the following pairs of criteria: lateral Kites angle and lateral Mearys angle; talotibial angle and lateral Mearys angle; radiographic longitudinal arch angle and lateral Mearys angle; talotibial angle and lateral Kites angle; foot dorsiflexion and foot dorsiflexion with great toe extension; and radiographic longitudinal arch angle and calcaneal pitch. Only moderate and weak correlations were found between clinical and radiographic parameters of the feet.
Conclusion. The relationship between clinical and radiographic parameters of the feet in patients with flatfoot is characterized by a moderate and weak correlation. Results suggest that the assessment of the clinical parameters of the feet in this population does not provide complete information about the degree of flatfoot.
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Kido, Masamitsu, Kazuya Ikoma, Kan Imai, Masahiro Maki, Ryota Takatori, Daisaku Tokunaga, Nozomu Inoue i Toshikazu Kubo. "Load Response of the Tarsal Bones in Patients with Flatfoot Deformity: In Vivo 3D Study". Foot & Ankle International 32, nr 11 (listopad 2011): 1017–22. http://dx.doi.org/10.3113/fai.2011.1017.
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Background: The objective of this study was to evaluate the bone rotation of each joint in the hindfoot and compare the load response in healthy feet with that in flatfeet by analyzing the reconstructive three-dimensional (3D) CT image data during weightbearing. Methods: CT scans of 21 healthy feet and 21 feet with flatfoot deformity were taken in non-load condition followed by full-body weightbearing load condition. The images of the hindfoot bones were reconstructed into 3D models. The volume merge method in three planes was used to calculate the position of the talus relative to the tibia in the tibiotalar joint, the navicular relative to the talus in talonavicular joint, and the calcaneus relative to the talus in the talocalcaneal joint. Results: The talar position difference to the load response relative to the tibia in the tibiotalar joint in a flatfoot was 1.7 degrees more plantarflexed in comparison to that in a healthy foot ( p = 0.031). The navicular position difference to the load response relative to the talus in the talonavicular joint was 2.3 degrees more everted ( p = 0.0034). The calcaneal position difference to the load response relative to the talus in the talocalcaneal joint was 1.1 degrees more dorsiflexed ( p = 0.0060) and 1.7 degrees more everted ( p = 0.0018). Conclusion: Referring to previous cadaver study, regarding not only the cadaveric foot, but also the live foot, joint instability occurred in the hindfoot with load in patients with flatfoot. Clinical Relevance: The method used in this study might be applied to clinical analysis of foot diseases such as the staging of flatfoot and to biomechanical analysis to evaluate the effects of foot surgery in the future. Level of Evidence: III
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Kim, Min Hwan, Sangha Cha, Jae Eun Choi, Minsoo Jeon, Ja Young Choi i Shin-Seung Yang. "Relation of Flatfoot Severity with Flexibility and Isometric Strength of the Foot and Trunk Extensors in Children". Children 10, nr 1 (22.12.2022): 19. http://dx.doi.org/10.3390/children10010019.
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Background: Flatfoot is a deformity in which the foot is flattened due to a decrease in or loss of the medial longitudinal arch. Statement of the problem: Few studies have investigated the relationship between the severity of flat feet, trunk strength, and joint flexibility. Purpose: The aim of this study is to investigate the relationship between the severity of flatfoot and joint flexibility and foot and trunk strength in children with flexible flatfoot. Methods: This study included 16 children (boys, 12; girls, 4; age, 4~8 years) with flexible flatfeet. We examined the resting calcaneal stance position angle (RCSPA) and foot posture index (FPI) scores for clinical severity and radiographic parameters, such as calcaneal pitch angle, talometatarsal angle (TMA), and talocalcaneal angle (TCA). Muscle thicknesses of the tibialis posterior (TP), peroneus longus (PL), and L1 multifidus were measured by sonography. Isometric contraction of ankle inversion, eversion in a seating position, and lumbar extension at a prone position were induced using a handheld dynamometer to measure the maximum muscle strength for each muscle. Beighton’s scoring system was used to assess joint flexibility by evaluating the hyperextension of the joint for each category when performing stretching motion. Spearman’s rank correlation coefficient for nonparametric data was used. Results: The FPI showed a moderately negative correlation with the muscle thickness of TP (r = −0.558, p = 0.009) and L1 multifidus (r = −0.527, p = 0.012), and the strength of the ankle inverter (r = −0.580 p = 0.005) and lumbar extensor (r = −0.436 p = 0.043). RCSPA showed a moderately positive correlation with TCA (r = 0.510, p = 0.006). Beighton’s score showed no significant correlation with all parameters. Conclusion: In children with flatfoot, FPI reflected the clinical severity; thus, the more severe the symptoms, the weaker the ankle inverter and lumbar extensor.
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Imhauser, Carl W., Nicholas A. Abidi, David Z. Frankel, Kenneth Gavin i Sorin Siegler. "Biomechanical Evaluation of the Efficacy of External Stabilizers in the Conservative Treatment of Acquired Flatfoot Deformity". Foot & Ankle International 23, nr 8 (sierpień 2002): 727–37. http://dx.doi.org/10.1177/107110070202300809.
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This study quantified and compared the efficacy of in-shoe orthoses and ankle braces in stabilizing the hindfoot and medial longitudinal arch in a cadaveric model of acquired flexible flatfoot deformity. This was addressed by combining measurement of hindfoot and arch kinematics with plantar pressure distribution, produced in response to axial loads simulating quiet standing. Experiments were conducted on six fresh-frozen cadaveric lower limbs. Three conditions were tested: intact-unbraced; flatfoot-unbraced; and flatfoot-braced. Flatfoot deformity was created by sectioning the main support structures of the medial longitudinal arch. Six different braces were tested including two in-shoe orthoses, three ankle braces and one molded ankle-foot orthosis. Our model of flexible flatfoot deformity caused the calcaneus to evert, the talus to plantarflex and the height of the talus and medial cuneiform to decrease. Flexible flatfoot deformity caused a pattern of medial shift in plantar pressure distribution, but minimal change in the location of the center of pressure. Furthermore, in-shoe orthoses stabilized both the hindfoot and the medial longitudinal arch, while ankle braces did not. Semi-rigid foot and ankle orthoses acted to stabilize the medial longitudinal arch. Based on these results, it was concluded that treatment of flatfoot deformity should at least include use of in-shoe orthoses to partially restore the arch and stabilize the hindfoot.
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Priya, Ananya, Ravi Kant Narayan i Sanjib Kumar Ghosh. "Flatfoot in the neglected age group of adolescents". European Journal of Anatomy 27, nr 2 (marzec 2023): 147–54. http://dx.doi.org/10.52083/ueam4094.
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The foot arches in humans are the complex musculo-skeletal-ligamentous structure that helps in shock absorption because of the elasticity and provides stability while transmitting the muscle force for walking. Primarily we observed the prevalence of flatfoot among adolescents going to college. Thereafter we determined the correlation of flatfoot with the body mass index and gender of the adolescents being studied. Footprint analysis of undergraduate students was obtained based on Harris – the Beath mat principle. Clarke’s angle, Chippaux-Smirak index, and Staheli arch index were observed in the footprints. Subsequently, the correlation between the flatfoot, body mass index, and gender of the participants was assessed. The prevalence of flatfoot in college-going adolescents was 18.28% by footprint analysis, presenting a female predilection (20% of the footprint analysis) for the condition. The most valid and reliable plantar arch index for diagnosing flatfoot was the Staheli arch index, followed by the Chippaux-Smirak index having a moderate to strong correlation (R = 0.7, 0.95; p < 0.05). Only 1.1% of females and up to 2.2% of males were observed to have flatfoot and were obese. Eighteen out of a hundred (approximately one–fifth) adolescents in the studied group had flatfoot. The gender predilection for females was observed. Contradictory to the findings of the previous study, obesity was not observed as a foot arch-altering factor in adolescents.
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Jiao, Xin, Tianyi Hu, Yongjin Li, Binbin Wang, Mirabel Ewura Esi Acquah, Zengguang Wang, Qianqian Chen, Yaokai Gan i Dongyun Gu. "Association between Elastic Modulus of Foot Soft Tissues and Gait Characteristics in Young Individuals with Flatfoot". Bioengineering 11, nr 7 (18.07.2024): 728. http://dx.doi.org/10.3390/bioengineering11070728.
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Flatfoot is a common foot deformity, causing foot pain, osteoarthritis of the midfoot, and even knee and hip dysfunction. The elastic modulus of foot soft tissues and its association with gait biomechanics still remain unclear. For this study, we recruited 20 young individuals with flatfoot and 22 age-matched individuals with normal foot arches. The elastic modulus of foot soft tissues (posterior tibial tendon, flexor digitorum brevis, plantar fascia, heel fat pad) was obtained via ultrasound elastography. Gait data were acquired using an optical motion capture system. The association between elastic modulus and gait data was analyzed via correlation analysis. The elastic modulus of the plantar fascia (PF) in individuals with flatfoot was higher than that in individuals with normal foot arches. There was no significant difference in the elastic modulus of the posterior tibial tendon (PTT), the flexor digitorum brevis (FDB), or the heel fat pad (HFD), or the thickness of the PF, PTT, FDB, and HFD. Individuals with flatfoot showed greater motion of the hip and pelvis in the coronal plane, longer double-support phase time, and greater maximum hip adduction moment during walking. The elastic modulus of the PF in individuals with flatfoot was positively correlated with the maximum hip extension angle (r = 0.352, p = 0.033) and the maximum hip adduction moment (r = 0.429, p = 0.039). The plantar fascia is an important plantar structure in flatfoot. The alteration of the plantar fascia’s elastic modulus is likely a significant contributing factor to gait abnormalities in people with flatfoot. More attention should be given to the plantar fascia in the young population with flatfoot.
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Henry, Jensen K., Jeffrey W. Hoffman, Jaeyoung Kim, Brett D. Steineman, Daniel R. Sturnick, Constantine A. Demetracopoulos, Jonathan T. Deland i Scott J. Ellis. "The Impact of Progressive Collapsing Foot Deformity on Foot & Ankle Kinematics and Plantar Pressure During Simulated Gait". Foot & Ankle Orthopaedics 7, nr 1 (styczeń 2022): 2473011421S0023. http://dx.doi.org/10.1177/2473011421s00237.
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Category: Basic Sciences/Biologics; Hindfoot Introduction/Purpose: Progressive collapsing foot deformity (PCFD) is a 3-dimensional pathology associated with insufficiency of the posterior tibial tendon (PTT), ligamentous failure, joint malalignment, and aberrant plantar force distribution. Existing knowledge of PCFD consists of static measurements, which provide information about the structure of the foot but none about its function. Cadaveric gait models provide an opportunity to measure motion both at the joints primarily affected in PCFD and the adjacent joints that are at risk for progressive subluxation and arthritis. This study sought to develop a flatfoot model for a robotic gait simulator and quantify gait kinematics and plantar pressure between normal and flatfoot conditions, which we hypothesized would be altered after the creation of a flatfoot deformity model. Methods: Cadaveric specimens were loaded on a 6-degree of freedom robotic gait simulator and the extrinsic tendons were attached to linear motors. Ground reaction forces and muscle forces were optimized utilizing an established iterative process. An 8-camera motion capture system was utilized to calculate joint kinematics using reflective markers attached by k-wires into bone. A plantar pressure mat attached to the force platform was used to calculate the center of pressure excursion index (CPEI) for each condition. The flatfoot model was created via sectioning of the spring ligament and medial talonavicular joint capsule followed by cyclic axial compression until 5-15° of talonavicular abduction was achieved in a static, loaded pose. Testing of the flatfoot state was then performed with inactivation of the PTT. Bias-corrected bootstrapped 95% confidence intervals were constructed from the repeated measures difference between flatfoot and normal conditions. Paired t-tests were used to compare the CPEI between conditions. Results: Twelve mid-tibia cadaveric specimens (mean age 73 years, 8 female) with no prior foot/ankle surgery were used. There were significant differences in kinematics between normal and PCFD conditions at the ankle, subtalar, and talonavicular joints (Figure). There was significantly increased ankle plantar flexion in flatfoot in the first 80% of stance phase. There was significantly greater subtalar eversion in flatfoot compared to normal from 10-90% of stance phase. Talonavicular abduction and eversion were also significantly greater in flatfoot from 10-100% of stance. The CPEI was significantly decreased in the flatfoot condition (Figure), indicating a medialization in center of pressure (p<0.0001). Conclusion: The results from this study support our hypothesis of altered kinematics and plantar pressure after flatfoot deformity creation and corroborate previous biomechanical studies of static alignment in PCFD. Increased talonavicular abduction and subtalar eversion are hallmarks of flatfoot deformity, and increased ankle plantarflexion may represent the plantarflexed position of the talus in PCFD. In addition, plantar pressure was significantly medialized with flatfoot deformity. These findings highlight the utility of the gait simulator as a tool for future study of PCFD, especially for analysis of deformity patterns and the specific effects of individual interventions.
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Tseng, Yao-Hsuan, i Zong-Hong Lin. "Wearable Foot Pressure Sensing System for Fallen Arch Analysis". ECS Meeting Abstracts MA2023-01, nr 34 (28.08.2023): 1901. http://dx.doi.org/10.1149/ma2023-01341901mtgabs.
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The main purpose of this research is to distinguish the extent of fallen arch by analyzing the center of foot pressure when people are walking. Fallen arch is often called the flatfoot. There are two types of flatfoot, the rigid flatfoot and the acquired flatfoot. The rigid flatfoot is because of bones formation, and people often get rigid flatfoot when they are young. The acquired flatfoot occurs usually on adults because of the walking postures, shoe types, weight and so on. Since these reasons, it is possible that we can improve or prevent the acquired flatfoot through wearing orthotic insoles or changing the walking posture. That’s the reason why our research is focusing on the acquired flatfoot. In this research, we develop a wearable foot pressure sensing system, consist of wireless Bluetooth transmit module and sensing insoles. The wireless Bluetooth transmit module helps to accomplish our measuring system as a wearable device. The sampling rate of wireless Bluetooth transmit module is one thousand samples per second. As a result, we can get a very detailed track on the walking motions. The sensing insoles are made of triboelectric nanogenerator (TENG) technology. The working principle of TENG is based on the coupling of triboelectric effect and electrostatic induction. Depending on the property of triboelectric generation of different materials and through continuous contact and separation, there is an electrostatic induction and current flow between the triboelectric layers and the electrodes, thus causing the potential difference. By detecting the potential differences, we can get the signals of pressure, so we can calculate the center of foot pressure and compare with the standard to check which walking posture we can apply to improve the fallen arch and find out where the center of foot pressure should be placed. Using this system, we can get the real-time foot pressure information and collect the information anytime and anywhere, accomplishing the smart medical.
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Xu, Liya, Hongyi Gu, Yimin Zhang, Tingting Sun i Jingjing Yu. "Risk Factors of Flatfoot in Children: A Systematic Review and Meta-Analysis". International Journal of Environmental Research and Public Health 19, nr 14 (6.07.2022): 8247. http://dx.doi.org/10.3390/ijerph19148247.
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Background: This study aimed to explore the risk factors for flatfoot in children and adolescents to provide a reference basis for studying foot growth and development in children and adolescents. Methods: We examined the cross-sectional research literature regarding flatfoot in children and adolescents published in the past 20 years, from 2001 to 2021, in four electronic databases: PubMed, Web of Science, EBSCO, and Cochrane Library. Two researchers independently searched the literature according to the inclusion and exclusion criteria and evaluated the literature quality of the selected research; from this, a total of 20 articles were included in our review. After the relevant data were extracted, the data were reviewed using Manager 5.4 software (The Cochrane Collaboration, Copenhagen, Denmark), and the detection rate and risk factors for flatfoot in children were analyzed. Results: In total, 3602 children with flatfoot from 15 studies were included in the analysis. The meta-analysis results showed that being male (OR = 1.33, 95% CI: 1.09, 1.62, p = 0.005), being aged <9 years (age <6, OR = 3.11, 95% CI: 2.47, 3.90, p < 0.001; age 6–9 years, OR = 0.54, 95% CI: 0.41, 0.70, p < 0.001), joint relaxation (OR = 4.82, 95% CI: 1.19, 19.41, p = 0.03), wearing sports shoes (OR = 2.97, 95% CI: 1.46, 6.03, p = 0.003), being a child living in an urban environment (OR = 2.10, 95% CI: 1.66, 2.64, p < 0.001) and doing less exercise (OR = 0.25, 95% CI: 0.08, 0.80, p = 0.02) were risk factors for the detection of flatfoot. Conclusion: In summary, the detection rate of flatfoot in children in the past 20 years was found to be 25% through a meta-analysis. Among the children included, boys were more prone to flatfoot than girls, and the proportion of flatfoot decreased with age.
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Walley, Kempland C., Gearin Greene, Jesse Hallam, Paul J. Juliano i Michael C. Aynardi. "Short- to Mid-Term Outcomes Following the Use of an Arthroereisis Implant as an Adjunct for Correction of Flexible, Acquired Flatfoot Deformity in Adults". Foot & Ankle Specialist 12, nr 2 (12.04.2018): 122–30. http://dx.doi.org/10.1177/1938640018770242.
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Background. The use of an arthroereisis implant for the treatment of adolescent flatfoot deformity has been described. However, data that address the outcomes of patients treated with an arthroereisis implant in adults are limited. The purpose of this study was to investigate the radiographic and clinical outcomes and complications following the use of a subtalar arthroereisis implant as an adjunct for correction acquired flatfoot deformity secondary to posterior tibial tendon dysfunction. Methods. A retrospective case-control study was performed querying all patients undergoing surgical flatfoot correction between January 1, 2010 and January 1, 2015. The experimental group included patients undergoing arthroereisis augmentation at the time of flatfoot correction. Patients undergoing the same flatfoot correction without the use of an arthroereisis implant were used as controls. Radiographic measurements were evaluated preoperatively and at final radiographic follow-up and included talonavicular (TN) coverage angle, and lateral talar–first metatarsal angle (T1MA). Patient-reported outcomes were assessed using preoperative visual analog scale (VAS) pain scores and postoperative Short Form–36, VAS, and satisfaction at final orthopedic follow-up. Results. A total of 15 patients underwent flatfoot correction and were augmented with an arthroereisis implant and were matched with 30 controls. Postoperative, mid-term T1MA and regional analysis was found to be improved in the experimental group versus control. Patients undergoing adjunct subtalar arthroereisis demonstrated an increased likelihood of achieving radiographically normal talonavicular coverage <7° compared with our control group at follow-up. Conclusions. The adjunct use of an arthroereisis implant resulted in improved and maintained radiographic and clinical measurements in patients undergoing stage II flatfoot. Clinical Significance. These results suggest utility of a subtalar arthroereisis implant as an adjunct to flatfoot correction with little additional risk of harm to the patient. Levels of Evidence: Level III: Case-control study
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Mataczyński, Krzysztof, Mateusz Pelc, Halina Romualda Zięba i Zuzana Hudakova. "Adult Acquired Flatfoot". Acta Balneologica 62, nr 1 (styczeń 2020): 55–59. http://dx.doi.org/10.36740/abal202001110.
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Acquired adult flatfoot is a three-dimensional deformation, which consists of hindfoot valgus, collapse of the longitudinal arch of the foot and adduction of the forefoot. The aim of the work is to present problems related to etiology, biomechanics, clinical diagnostics and treatment principles of acquired flatfoot. The most common cause in adults is the dysfunction of the tibialis posterior muscle, leading to the lack of blocking of the transverse tarsal joint during heel elevation. Loading the unblocked joints consequently leads to ligament failure. The clinical image is dominated by pain in the foot and tibiotarsal joint. The physical examination of the flat feet consists of: inspection, palpation, motion range assessment and dynamic force assessment. The comparable attention should be paid to the height of the foot arch, the occurrence of “too many toes” sign, evaluate the heel- rise test and correction of the flatfoot, exclude Achilles tendon contracture. The diagnosis also uses imaging tests. In elastic deformations with symptoms of posterior tibial tendonitis, non-steroidal anti-inflammatory drugs, short-term immobilization, orthotics stabilizing the medial arch of the foot are used. In rehabilitation, active exercises of the shin muscles and the feet, especially the eccentric exercises of the posterior tibial muscle, are intentional. The physiotherapy and balneotherapy treatments, in particular hydrotherapy, electrotherapy and laser therapy, are used as a support. In advanced lesions, surgical treatment may be necessary, including plastic surgery of soft tissues, tendons, as well as osteotomy procedures.
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Vukasinovic, Zoran, Dusko Spasovski, Dragana Matanovic, Zorica Zivkovic, Vladan Stevanovic i Radmila Janicic. "Flatfoot in children". Acta chirurgica Iugoslavica 58, nr 3 (2011): 103–6. http://dx.doi.org/10.2298/aci1103103v.
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Foot arches are defined by the position of bones and stabilized by active and passive soft tissue structures. The most significant foot arches are longitudinal, medial and lateral. During lifetime they develop and change, while the most significant disorder represents the flatfoot. During the first two years of life, the flatfoot in full weight bearing position is considered a normal physiological condition, while in later age it represents a deformity requiring additional diagnostics and treatment. The flexible flatfoot is caused by ligamentous laxity, it is mostly pain-free and is treated symptomatically (prescription of adequate shoes and kinesitherapy). The rigid foot is most often caused by bone changes (tarsal coalition, vertical congenital talus) occurring idiopathically or within neuromuscular pathological conditions, with mostly present pain problems. In such cases treatment is also initiated by non-surgical methods, however, some type of surgical treatment is most frequently necessary to be used.
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Roberts, Lauren E., i Scott J. Ellis. "The Collapsing Flatfoot". Techniques in Foot & Ankle Surgery 18, nr 4 (grudzień 2019): 185–93. http://dx.doi.org/10.1097/btf.0000000000000238.
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Yang, Zongyu, Fei Liu, Liang Cui, Heda Liu, Junshui Zuo, Lin Liu i Sentian Li. "Adult rigid flatfoot". Medicine 99, nr 7 (luty 2020): e18826. http://dx.doi.org/10.1097/md.0000000000018826.
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Walters, Jeremy L., i Samuel S. Mendicino. "Flexible Adult Flatfoot". Clinics in Podiatric Medicine and Surgery 31, nr 3 (lipiec 2014): 349–55. http://dx.doi.org/10.1016/j.cpm.2014.03.006.
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Sheikh Taha, Abdel Majid, i David S. Feldman. "Painful Flexible Flatfoot". Foot and Ankle Clinics 20, nr 4 (grudzień 2015): 693–704. http://dx.doi.org/10.1016/j.fcl.2015.07.011.
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Irwin, Todd A. "Overcorrected Flatfoot Reconstruction". Foot and Ankle Clinics 22, nr 3 (wrzesień 2017): 597–611. http://dx.doi.org/10.1016/j.fcl.2017.04.004.
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WIEWIORSKI, M., i V. VALDERRABANO. "Painful Flatfoot Deformity". Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca 78, nr 1 (1.02.2011): 20–26. http://dx.doi.org/10.55095/achot2011/003.
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