Radl R, Fuhrmann G, Maafe M, Krifter R-M
Orthopädische Abteilung, Landeskrankenhaus Stolzalpe, A-8852, Stolzalpe, Österreich.
Orthopade. 2012 Apr;41(4):313-24; quiz 325-6. doi: 10.1007/s00132-012-1903-1.
The clinical finding of flatfoot is characterized by a flattening of the medial longitudinal arch and valgus deformity of the hindfoot. The differential diagnosis of flatfoot is the physiological, flexible, contracted flatfoot, which occurs as a congenital or acquired deformity. Congenital flatfoot deformity requires early intensive therapy, while a flexible flatfoot in children has a good prognosis and conservative treatment usually leads to a stable and sufficient load-bearing foot. Severe flatfoot in children can be corrected successfully by simple, minimally invasive procedures. In adults with symptomatic flatfoot, which usually occurs due to an insufficiency of the tendon of the tibialis posterior, conservative therapy with insoles, shoe modifications and physiotherapeutic measures can lead to significant improvement, otherwise surgical correction is recommended. Early, stage-appropriate therapy helps to prevent an impending decompensation of the hindfoot.
扁平足的临床特征为内侧纵弓变平以及后足外翻畸形。扁平足的鉴别诊断包括生理性、柔韧性、挛缩性扁平足，其可为先天性或后天性畸形。先天性扁平足畸形需要早期强化治疗，而儿童柔韧性扁平足预后良好，保守治疗通常可使足部稳定且具备足够的承重能力。儿童严重扁平足可通过简单的微创手术成功矫正。在有症状的成人扁平足患者中，通常是由于胫后肌腱功能不全所致，使用鞋垫、改良鞋子及物理治疗措施进行保守治疗可显著改善症状，否则建议进行手术矫正。早期、适时的治疗有助于防止后足即将出现的失代偿。
