Peroneal Spastic Flatfoot Research Articles

Tarsal anomalies and peroneal spastic flatfoot.

Recent literature on the etiology of peroneal spastic flatfoot, especially by Harris and Beath,1has stressed the role of congenital abnormalities in this condition. Sloman2in 1921, and later Badgley,3observed the association of fusion of the anterior process of the calcaneus to the navicular bone with this condition, though anatomically the anomaly had been described earlier.4A second type of tarsal anomaly, namely, a union between the talus and the calcaneus in the region of the sustentaculum, has been held by Harris and Beath to be a commoner and heretofore unrecognized cause of rigid flatfoot. These authors reported a group of 17 cases of peroneal spastic flatfoot in which 88% were the result of tarsal anomalies. Twelve consisted of a talocalcaneal bridge in the region of the posterior end of the sustentaculum tali, and three were calcaneonavicular bars. Since the above report was published, we

ETIOLOGY OF PERONEAL SPASTIC FLAT FOOT

1. Peroneal spastic flat foot is a term loosely and often inaccurately used to describe rigid valgus feet developing from widely different causes. 2. The most common causes are two anomalies of the bones of the tarsus—the calcaneonavicular bar, and the talocalcaneal bridge. The first was described in 1921 by Sloman and in 1927 by Badgley; the other is described for the first time in this paper as an etiological factor in rigid flat foot though it has been recognised by anatomists for fifty years as a skeletal variation. The term peroneal spastic flat foot, as applied to these cases, is inaccurate since there is no spasm of the peroneal muscles. The deformity is a fixed structural deformity due to anomalous bone structure, and the apparent spasm of peroneal muscles is in reality an adaptive shortening. A better term would be rigid flat foot due to talocalcaneal bridge or calcaneonavicular bar. 3. The smaller group of patients who suffer from inflammatory lesions of the tarsal joints, chiefly due to rheumatoid arthritis, do in fact develop valgus deformity from peroneal spasm. The resemblance between the two groups is superficial and it is limited to the apparent similarity of the deformity. Though it might be justifiable to designate this type as peroneal spastic flat foot, it would be better to use the more accurate title—arthritic flat foot with peroneal spasm. 4. Lipping of the upper margin of the talonavicular joint strongly suggests the existence of one or other of the congenital anomalies. Both anomalies are visualised only by special radiological projections.