Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
Int Orthop. 2023 Sep;47(9):2357-2368. doi: 10.1007/s00264-023-05837-3. Epub 2023 May 24.
Although flatfoot is a widespread human condition, historical medical texts and ancient illustrations on this deformity are extremely rare. Nowadays, doubts regarding its management remain unsolved. This historical review aims to identify the presence of pes planus since the prehistoric era and examine the treatments proposed over the centuries up to the present.
For this propose, we performed an extensive electronic search of the relevant literature, complemented by a manual search of additional sources from archaeological to artistic, literary, historical, and scientific accounts, describing flatfoot and its treatment in different eras.
Flatfoot accompanied the evolutionary timeline of human species: from Lucy Australopithecus to Homo Sapiens. It was described among various diseases suffered by Tutankhamun (1343-1324 B.C.), while the first anatomical description dates to Emperor Trajan (53-117 A.D.) and the medical studies of Galen (129-201 A.D.). It was also represented in the anatomical drawings of Leonardo da Vinci (1452-1519) and Girolamo Fabrici d'Acquapendente (1533-1619). Historically, the conservative treatment by insoles was the only one proposed until the nineteenth century. Since then, the most popular surgical procedures performed for correction have been osteotomies, arthrodesis, arthrorisis, and tendon lengthening and transfer.
During the centuries, conservative therapeutic strategies have not radically changed in their substance, while operative ones have become the protagonists during the twentieth century up to the present. Nevertheless, after more than 2000 years of history, there is no consensus regarding the best indication for the flatfoot and if it really needs to be treated.
尽管扁平足是一种广泛存在的人类病症，但关于这种畸形的历史医学文献和古代插图却极为罕见。如今，对于其治疗方法仍存在诸多疑问。本历史回顾旨在确定扁平足自史前时代以来的存在，并检查几个世纪以来直至现在提出的治疗方法。
为此，我们对相关文献进行了广泛的电子检索，并通过手动搜索考古学、艺术、文学、历史和科学等方面的其他来源进行了补充，描述了不同时代的扁平足及其治疗方法。
扁平足伴随着人类物种的进化历程：从露西南方古猿到智人。它被描述为图坦卡蒙（公元前 1343-1324 年）所患的各种疾病之一，而最早的解剖学描述可追溯到图拉真皇帝（公元 53-117 年）和盖伦（公元 129-201 年）的医学研究。莱昂纳多·达·芬奇（1452-1519 年）和吉罗拉莫·法布里奇奥·达·阿肯彭登特（1533-1619 年）的解剖图中也有扁平足的描绘。从历史上看，直到 19 世纪，仅提出了通过鞋垫进行保守治疗的方法。从那时起，为矫正而进行的最流行的手术方法包括截骨术、关节融合术、关节松解术以及肌腱延长和转移术。
几个世纪以来，保守治疗策略在本质上并没有发生根本变化，而手术治疗在 20 世纪至今成为了主角。尽管有 2000 多年的历史，但对于扁平足的最佳适应证以及是否确实需要治疗仍没有共识。
