It is most common in females over the age of 40, peaking at 55 years of age, with comorbidities including diabetes and obesity 1,3.ДЄny injury to the structures mentioned above maintaining the arch may lead to pes planus. These patients develop medial foot pain during late childhood or early adolescence as they increase their physical and sporting activities 3,6.Д®pidemiology and Risk factors for PreventionДЄdult acquired flatfoot is a debilitating condition that affects up to 5 million people within the US 4. Individuals with congenital pes planus may have tarsal coalition, an abnormal connection between tarsal bones due to incomplete differentiation of bones. Diabetics with Charcot neuroarthropathy from sensory neuropathy commonly have collapsed arches with rocker bottom deformity in severe cases 3. In severe cases, rupture of PTT occurs commonly at the region of hypovascularity 1.0-1.5 cm distal to the medial malleolus.

Dysfunction of the posterior tibial tendon(PTT) leads to pes planus of various degrees. Specific injuries that can lead to pes planus include fractures of the navicular, first metatarsal, or calcaneal bones, and/or trauma to the Lisfranc joint, plantar fascia, and deltoid/spring ligament. In long-standing cases, the ankle may be involved as well 13. It combines multiple static and dynamic deformities, with flattening of the medial arch, eversion of calcaneus, and abduction of forefoot relative to the hindfoot 9. Adult acquired flatfoot deformity (AAFD) is a complex pathology defined by the collapse of the medial longitudinal arch of the foot with continued progressive deformity of the foot and ankle 5.

Pes valgus