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Pes Planus

INTRO
CAUSES
SYMPTOMS
DIAGNOSIS
TREATMENTS OPTIONS
COMPLICATIONS
ORTHOFIX SOLUTIONS

Pes Planus

The foot must act as a reliable landing point when putting the foot down, usually heel first, and as a rigid taking off point when walking or running. There are medial and lateral arches that run the length of the foot and are supported by ligaments, one of which is called the spring ligament. The arches are supported by a combination of the shape of the bones, the integrity of the ligaments and the function of the supporting muscle system, which is regulated by feedback from the nerves supplying the foot. Problems with any of these mechanisms may lead to loss of longitudinal arch shape and flat foot.

Pes planus is more commonly known as flat-foot. Both children and adults may be flat-footed and it’s estimated that the prevalence of pes planus in the general population is about 20-30 percent. In fact, normal arch development in children does not typically occur until between 3 and 5 years old.6 Slightly-lowered arches are usually symptom-free. Adult Acquired Flatfoot Deformity (AAFD) may develop from a normal foot in adult life.

Pes normal
Normal Foot
Pes planus
Pes Planus

Causes

In pathological flat foot, the arch of one foot or both feet has either not developed normally, or an injury or condition, such as rheumatoid arthritis, stroke or diabetes, has produced it. It may develop as a result of degenerative changes in joints and/or ligaments; this will tend to be in older patients and people who are very overweight. It may also occur as a result of trauma to the bones and/or ligaments. An increasingly common cause seems to be neuropathic problems secondary to diabetes, as an early manifestation of Charcot foot.

Symptoms

The arch of the foot is lowered or flattened out, depending on the severity. Issues such as discomfort and chronic pain can arise if, for example, there is a minor injury, changes in the work environment (such as long periods of standing), sudden weight gain, poorly-fitted footwear, and excessive standing, walking, jumping or running.6

Diagnosis

Diagnosis is usually by clinical examination. In young people, the flat foot that is apparent when standing disappears when they stand on tip toe, and the normal arch appears. This is flexible flat foot, is usually symptomless and requires no treatment. Adults with AAFD will normally have a rigid flat foot that does not correct on tip toe. X-rays may be helpful when there is a history of injury, but may not be necessary.

Treatment Options

Management in less-severe cases generally consists of wearing spacious, comfortable footwear with good arch support, possibly supplemented by padding or orthotics, in order to balance and cushion the foot.6 The object of treatment is to restore anatomy and function as much as possible. Surgery sometimes with osteotomy (the surgical cutting of a bone or removal of a piece of bone) may be necessary if the deformity is fixed.7 Bone grafting to replace lost bone may be necessary.7 Each case is different and there are many types of treatments; it is best to discuss your treatment in detail with your specialist rather than attempt to summarize the options here.

Complications

If not treated, certain cases of pes planus can result in severe deformity and early onset of arthritis of the foot and ankle, causing severe pain and significantly reducing the ability to walk, even while wearing orthotics. After surgery, you may need to wear orthotics for the rest of your life.

MiniRail

Important safety information: Download the Product Instructions For Use.

The MiniRail External Fixation System consists of small rails and screws for fixation of small bones when a condition does not allow for implanting internal devices. The MiniRail is designed to help with a variety of deformity corrections and lengthening procedures of small bones and joints in the foot and upper limb.

KNOW MORE
  1. Healthwise. Flatfoot (pes planus). Atlanta: WebMD; 2014. http://www.webmd.com/a-to-z-guides/flatfoot-pes-planus-topic-overview [Accessed October 2014].
  2. Miller MD, Thompson SR, Hart JA. Review of Orthopaedics. Philadelphia: Saunders/Elsevier Health Sciences; 2012.
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ORTHOFIX SOLUTIONS

The Agile Nail is intended for insertion in the medullary canal of a femur for the alignment and the stabilization of fractures and for the correction of deformities. It is indicated for the treatment of subtrochanteric fractures and of femoral shaft fractures, in pediatric patients, with the exception of newborns and infants, and in adult patients with an appropriate medullary canal. The indications include:

  • Prophylactic nailing of impending pathologic fractures;
  • Fixation of femurs that have been surgically prepared (osteotomy);
  • Non-unions and malunions;
  • Reconstruction following tumor resection and grafting and bone lengthening and shortening.

The Orthofix Ankle Hindfoot Nailing (AHN) System is intended to facilitate tibiotalocalcaneal arthrodesis (fusion). Specific indications include:

  • Avascular necrosis of the talus
  • Failed total ankle arthroplasty
  • Trauma (malunited tibial pilon fracture)
  • Severe deformity or instability as a result of talipes equinovarus, cerebral vascular accident, paralysis or other neuromuscular disease
  • Revision ankle arthrodesis
  • Neuroarthropathy
  • Rheumatoid arthritis
  • Osteoarthritis
  • Pseudoarthrosis
  • Post-traumatic arthrosis
  • Previously infected arthrosis
  • Charcot foot
  • Severe endstage degenerative arthritis
  • Severe defects after tumor resection
  • Pantalar arthrodesis

INTENDED PURPOSE
The Guided Growth Plate Systems are plates intended to provide bone fixation.

INDICATIONS FOR USE
The Guided Growth Plate Systems are indicated for gradually correcting deformities of long bones in growing children. Specific acquired or congenital patterns of bone deformity for which the device will be indicated include:
• Valgus, varus or flexion, extension deformities of the knee (femur and/or tibia);
• Valgus, varus, or plantar flexion deformities of the ankle.

Fitbone is an intramedullary lengthening system for limb lengthening of the femur and tibia.

The G-Beam Fusion Beaming System is intended to be inserted in the bones of the foot and ankle for alignment, stabilization and fixation of various fractures and osteotomies, fusions and reconstructions. It is indicated for fracture and osteotomy fixation, reconstruction procedures, non-unions and fusions of bones of the foot and ankle including metatarsals, cuneiforms, cuboid, navicular, calcaneus and talus. Specific example: medial and lateral column fusions resulting from neuropathic osteoarthropathy (Charcot osteoarthropathy).

The JuniOrtho Plating System is indicated for internal fixation and stabilization of femoral and tibial fractures, osteotomies, mal-unions and non-unions. Indications include:

  • Varus, valgus, rotational and/or shortening osteotomies
  • Femoral neck and/or pertrochanteric fractures
  • Proximal and distal metaphyseal fractures
  • Pathological and impeding pathological fractures

Use of the JuniOrtho Plating System is indicated in pediatric (excluding newborns) and small stature adult patients.

Indications:

  • Short Stature
  • Bone loss
  • Open fractures​
  • Non-union
  • Angular deformities

Indications:

  • Metacarpal and metatarsal lengthening
  • Calcaneal lengthening
  • Pediatric forearm lengthening
  • Metacarpal, metatarsal and phalangeal lengthening
  • Joint arthrodesis
  • Joint stiffness; Comminuted intra-articular fractures
  • Soft tissue correction in patients with neurological disorders (e.g. cerebral palsy)
  • Arthrodesis of the 1st carpo-metacarpal joint following soft tissue correction
  • Complex upper extremity deformities
  • Hand contractures
  • Wrist contractures
  • Indicated for pediatrics through adult

INTENDED PURPOSE

The SOLE™ Medial Column Fusion Plate (SOLE MCF) is intended to provide bone fixation.

INDICATIONS FOR USE

The SOLE MCF is indicated for orthopedic applications within the anatomical area of the foot and ankle, including but not limited to the medial column (consisting of the first metatarsal, medial cuneiform, navicular and talus). Specific indicated procedures include:

  • Arthrodesis
  • Joint depression stabilization
  • Fracture and/or osteotomy fixation
  • Reconstruction
  • Revision

to be performed for conditions such as Charcot neuroarthropathy.

The TL-HEX system is intended for limb lengthening by metaphyseal or epiphyseal distractions, fixation of open and closed fractures, treatment of non-union or pseudoarthrosis of long bones and correction of bony or soft tissue defects or deformities.

INDICATIONS:

  • Fractures
  • Non-unions/ malunions
  • Limb lengthening
  • Deformity corrections
  • For pediatrics, the same indications apply provided a growth plate is not compromised

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This website is for educational purposes only and is not a substitute for a consultation with your physician or health care professional. The information provided herein is a service and should be viewed only as opinion. The information contained herein has been obtained from sources deemed ethical and reliable, but completeness is not guaranteed.

ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL ABOUT DIAGNOSIS AND TREATMENT INFORMATION.

This site is intended for U.S. patients and their caregivers.

CONTACT

ORTHOFIX MEDICAL INC.
3451 Plano Parkway
Lewisville, TX 75056
USA

Phone: 214.937.2000
Email: [email protected]

Full prescribing information can be found in product labeling.

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

© 2022 Orthofix Srl
Agile Nail™, Ankle Hindfoot Nailing System™, eight-Plate Guided Growth System™, eight-Plate Guided Growth System+™, Fitbone™, G-Beam™, JuniOrtho™ Plating System, LRS Advanced™, Minirail™, SOLE™ Medial Column Fusion Plate, TL-HEX TrueLok Hexapod System™ are trademarks or registered trademarks of Orthofix S.r.l. TrueLok is a trademark or registered trademark exclusively licensed to Orthofix Medical Inc., and its affiliate companies. The relevant short forms, as indicated in brackets next to each registered trademark, are also used alone as distinctive signs in the name and on behalf of Orthofix S.r.l. and are protected in accordance with the provisions set by the local Intellectual Property law.