HIGH YIELD RIGID FLATFOOT

Question 1

What are three main etiologies of a Rigid Flatfoot?

Answer 1

-tarsal coalition, fracture, and arthritic disease

Question 2

What can a Rigid Flatfoot tarsal coalition be?

Answer 2

-osseous, fibrous, or cartilaginous

Question 3

A tarsal coalition can be most commonly seen between what bones?

Answer 3

-Talus-Calcaneus, Calcaneous-Navicular

Question 4

What percentage of Talo-calcaneal coalitions are bilateral?

Answer 4

-50%

Question 5

Where on the talus are the most common sites of tarsal coalition?

Answer 5

-middle facet and posterior facet

Question 6

What percentage of Calcaneo-navicular coalitions are bilateral?

Answer 6

-60%

Question 7

How is the STJ motion of a rigid flatfoot tarsal coalition?

Answer 7

-limited or absent motion

Question 8

What is a Rigid Flatfoot fracture?

Answer 8

-any fracture or healed fracture that involves the STJ, calcaneo-cuboids joint
or talo-nvicular joints

Question 9

What can pronation of the STJ do?

Answer 9

-reduce discomfort between affected joints

Question 10

Any arthritic process that damages the articular surface of the joint can result in what?

Answer 10

-a rigid flatfoot

Question 11

Flatfoot results with arthritis of what?

Answer 11

-STJ, Calcaneo-navicular, and talo-navicular

Question 12

If the Peroneus Brevis muscle goes into spasm what can happen?

Answer 12

-a rigid flatfoot

Question 13

What can you do to get rid of Peroneal Spasm?

Answer 13

-numb up the common fibular nerve

Question 14

With regards to a Peroneal Spasm what can pronation of the STJ cause?

Answer 14

-decreases compression at the joint, increases instability, and relieves pain

Question 15

What are some of the etiologies of a Flexible Flatfoot?

Answer 15

-ligamentous, pre-hallux, Morton’s foot, neuromuscular, and ontegenic

Question 16

What is the most common cause of a Flexible Flatfoot?

Answer 16

-ontegenic (compensatory, excessive medial loading)

Question 17

Any condition that results in ligamentous laxity can result in what?

Answer 17

-flexible flatfoot

Question 18

Equinus results in what?

Answer 18

-STJ pronation

Question 19

What are some conditions that can present with ligamentous laxity?

Answer 19

-Marfan’s syndrome, Down’s syndrome, and Alers Danlos

Question 20

What is the Os Tibial Externum?

Answer 20

-accessory ossicle of the navicular

Question 21

What is present in4-14% of normal feet?

Answer 21

-pre-hallux

Question 22

What can insert into the Os Tibiale Externum?

Answer 22

-Tibialis Posterior Muscle

Question 23

If the Tibialis Posteiror muscle inserts into this accessory ossicle what results?

Answer 23

-altered pull of the PT tendon

Question 24

What can an altered pull of the PT tendon result in?

Answer 24

-loss of mechanical efficiency of prime supinator of the STJ which leads to
flexible flatfoot

Question 25

What is Morton’s foot of the flexible flatfoot?

Answer 25

-a foot with a short first ray (seen on an AP radiograph)

Question 26

What does a short first ray result in?

Answer 26

-the first ray always functioning dorsiflexed relative to the other metatarsals and the ground

Question 27

What is a compensation of Morton;s Foot?

Answer 27

-to pronate the STJ to get the first ray to the ground

Question 28

T/F Any condition that improves the mechanical advantage of the Peronous Brevis muscle will cause a flexible flatfoot

Answer 28

-true

Question 29

What is the most common cause of flexible flatfoot?

Answer 29

-compensation for biomechanical faults due to development (ontogenic causes)

Question 30

What is one of the primary compensations for equinus?

Answer 30

-to pronate the STJ throughout the stance phase of gait