Accessory navicular is a congenital anomaly of the tuberosity of the navicular from a secondary ossification center. The accessory navicular is occasionally the source of pain and local tenderness over the medial side of midfoot. If conservative treatment fails for the painful accessory navicular, surgical treatment is required. There are several surgical option for accessory navicular, which vary from simple excision, percutaneous drilling, modified Kidner procedure and osteosynthesis of the accessory ossicle to the navicular body. In addition, symptomatic flatfoot deformity should be addressed concomitantly.
Congenital Abnormalities ; Flatfoot ; Mandrillus

Flatfoot is a common foot disorder. Some modifications by orthotic shoes for the flatfoot have been prescribed, however their effectivenesses are not fully proven yet. We have tried to validate the effectivenesses of conventional orthotic shoes for the flatfoot patients. We assessed the static and dynamic pressure, dynamic pressure-time integral, and relative impulse with and without wearing orthotic shoes. Thirteen subjects with the flatfoot were included in this study. The results showed the positive effects of orthotic shoes for the subjects. Especially the dynamic pressure-time integral values revealed the significantly reduced values at the medial side of midfoot, which meant the functional improvement of flatfoot status. We have concluded that the use of conventional orthotic shoes for the flat foot patients would be effective for properly selected patients, if there is no other associated abnormality.
Flatfoot* ; Foot* ; Humans ; Shoes*

Congenital vertical talus associating tarsal coalition, which is a very anomalous condition and causes severe rigid flat foot, is presented with literary reviews. This case was treated with soft tissue release and triple arthrodesis.
Arthrodesis ; Flatfoot ; Talus

We present the case of an adult flexible flatfoot that was managed with dynamic and multiplarnar approaches which consist of Young's tenosuspension, Evans osteotomy, posterior tibialis tendon advancement with flexor digitorum longus tendon transfer and Lapidus procedure.
Adult* ; Flatfoot* ; Humans ; Osteotomy ; Tendon Transfer ; Tendons

OBJECTIVE: To see how people think about their own feet, and evaluate whether there are correlations among self-awareness of the participants and clinical examination findings. METHODS: Adult twins and their families who participated in the Healthy Twin study from May 2008 to April 2010 were recruited. Participants were asked whether they thought their feet were normal, flat, or cavus. The lateral talometatarsal angles were measured on foot X-rays to determine the foot arch height. Using the podoscopic footprints taken with the podobaroscope, the Staheli arch index was also measured. Kappa statistics were used to calculate degree of agreement among the three measurement methods. RESULTS: Self-awareness and radiographic findings were significantly different (Pearson chi-square test, p=0.000) and only slightly agreed (kappa measure of agreement=0.136, p=0.000). Self-awareness and podoscopy results revealed a significant difference (Pearson chi-square test, p=0.000), with only slight agreement (kappa measure of agreement=0.072, p=0.000). CONCLUSION: There is significant disagreement between patients' perception of their feet and actual test results. Many people may have an incorrect assumption about their own foot conditions that may be reflected in improper management. Dissemination of accurate information about foot disorders by foot clinicians would be helpful.
Adult ; Flatfoot ; Foot Deformities ; Foot* ; Humans ; Twins

OBJECTIVE: This study was aimed to demonstrate definite diagnostic radiologic criteria between normal and flatfoot. METHOD: Sixty healthy subjects and fifty two flatfoot cases were evaluated by radiologic measurements. We evaluated criteria for longitudinal arch curve by measuring of calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: Over 10 years old, there was significant correlation between normal group and flatfoot in calcaneal pitch, talocacaneal angle, difference angle, metatarsal angle, navicular height I and II. But below 10 years old, there was difference in only talometatarsal angle and metatarsal angle. Therefore talometatarsal angle and metartarsal angle are valuable in diagnosis of flatfoot in all age group. CONCLUSION: In diagnosis of flatfoot, variable radiologic measurement are clinically significant.
Child ; Diagnosis ; Flatfoot* ; Humans ; Metatarsal Bones

Acquired adult flatfoot deformity is characterized by flattening of the medial longitudinal arch and dysfunction of the posteromedial soft tissues, including the posterior tibial tendon. When the non-operative treatment fails to result in improvement of symptoms, surgery should be considered. Operative techniques include flexor digitorum longus tendon transfer, calcaneal medial slide osteotomy, lateral column lengthening, and arthrodesis of the hindfoot. The principle of correcting the deformity while avoiding overcorrection and excessive stiffness is important in achievement of good outcomes in these patients.
Adult* ; Arthrodesis ; Congenital Abnormalities ; Flatfoot* ; Humans ; Osteotomy ; Tendon Transfer ; Tendons

OBJECTIVE: To clarify the relationship of the initial radiologic and a biomechanical parameter at first clinical visit, and define the effectiveness of modified insole, following insole fitting in children with flexible flatfoot. METHODS: Children aged less than 13 years with flexible flatfoot were enrolled. The total number of subjects was 66 (33 boys, 33 girls). The subjects were divided into 5 subgroups, based on age: 1–2, 3–4, 5–6, 7–9, and 10–12 years. The mean time period between the initial & final examination for their resting calcaneal stance position angle (RCSPA) was 24 months. Radiography quantified the deformity by measuring angles, including the talometatarsal angle, the metatarsal angle, and the calcaneal pitch angle. RESULTS: From the angles measured on radiographs, only the talometatarsal angle showed a statistically significant correlation to the initial RCSPA (r=-0.578 for right side, r=-0.524 for left side; p<0.01). The mean RCSPA improved in all subgroups of subjects following insole fitting. Moreover, in children younger than 7 years, the improvement in RCSPA from the insole fitting was greater compared to children aged 7 years and older. CONCLUSION: The insole has additionally beneficial effects in all populations younger than 13 years. However, there might exist a hidden effect of normal structural pedal alignment during growth accompanied with bony maturation and developmental process. To date, it is controversial whether the treatment of flexible flatfoot is necessary in the vast majority of cases, or simple observation and advice to parents would suffice.
Child* ; Congenital Abnormalities ; Flatfoot* ; Humans ; Metatarsal Bones ; Parents ; Radiography

Cause of flexible flat foot is predominantly idiopathic but pediatric flexible flatfoot is typically congenital. Neuromuscular disorders, tarsal coalition and prehallux are possible causes and there has been a controversy for diagnosis and surgical treatment guideline. Therefore we present 11-year old male with prehallux and flexible flat foot who was treated with Kidner procedure and subtalar arthroereisis using Kalix endoprothesis and reported good clinical outcome at 2-years follow up postoperatively.
Adolescent* ; Child ; Diagnosis ; Flatfoot ; Follow-Up Studies ; Humans ; Male

PURPOSE: The author evaluated the clinical and radiological results after wearing the medial arch supports in children. MATERIALS AND METHODS: 103 patients who had symptomatic flat feet were evaluated from march, 2002 to may 2009. All patients wore the medial arch supports according to the symptoms. We measured parameters at weight-bearing radiographs before and after medial arch support were worn. We also evaluated the clinical scores using the AOFAS score. RESULTS: Mean age of patients was 97 months (11-204 months), all foot of patients involved bilaterally. Mean talo-first metatarsal angle of right foot was 17.7+/-9.4 and left foot was 19.96+/-9.5 degrees at AP radiograph in pre-wearing state. Mean calcaneal pitch angle of right foot was 12.0+/-5.3 and left foot was 11.9+/-5.8 degrees at lateral radiograph in pre-wearing state. Mean talo-first metatarsal angle of right foot was 14.4+/-8.05 and left foot was 13.1+/-8.77 degrees at AP radiograph in post-wearing state. Mean calcaneal pitch angle of right foot was 16.4+/-5.75 left foot was 16.5+/-5.6 degrees at lateral radiograph in post-wearing state. The radiographic angles between pre-wearing and post-wearing state were statistically significant (p<0.05). Mean pre-wearing AOFAS hindfoot score was 66.7+/-9.25, midfoot score was 60.0+/-9.34 forefoot score was 57.1+/-11.8. Mean post-wearing AOFAS hindfoot score was 73.2+/-9.73, midfoot score was 68.1+/-10.1, forefoot score was 67.2+/-11.4. The forefoot score was highest improving scores among the AOFAS scores. CONCLUSION: From our study, we concluded that medial arch support was effective for symptomatic flat feet of children in radiological and clinical results from our study.
Child ; Flatfoot ; Foot ; Humans ; Metatarsal Bones ; Weight-Bearing