Acquired adult flat foot due to isolated plantar calcaneonavicular (spring) ligament insufficiency with a normal tibialis posterior tendon

M. Tryfonidis, W. Jackson, R. Mansour, P. H. Cooke, J. Teh, S. Ostlere, R. J. Sharp

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)

Abstract

Background: We present nine cases of acquired flat foot deformity (AFFD) in adults caused by isolated spring ligament insufficiency. Methods: We present the clinical sign that allows differentiation of this diagnosis from posterior tibialis tendon (PTT) dysfunction namely the ability to single leg tiptoe, but with persistent forefoot abduction and heel valgus. In addition we illustrate the unique radiological features which allow confirmation of the diagnosis. Only a solitary previous case report has documented this alternative aetiology of AFFD; in that case, diagnosis was made intra-operatively. Results: Six patients have been managed with orthoses. Three patients underwent surgery; one patient who presented early had isolated repair of the spring ligament complex. The remaining two required a calcaneal osteotomy and flexor digitorum longus transfer as for a PTT reconstruction. Conclusion: We propose that early diagnosis (with ultrasound confirmation) and management of this condition would offer a better prognosis and allow less interventional surgery.

Original languageEnglish
Pages (from-to)89-95
Number of pages7
JournalFoot and Ankle Surgery
Volume14
Issue number2
DOIs
Publication statusPublished - 2008

Keywords

  • Adult flat foot deformity
  • Isolated spring ligament insufficiency

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