what is congenital pes planus

Congenital pes planus, left foot. Q66.52 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM Q66.52 became effective on October 1, 2018.

Full Answer

What is pes planus in children?

Pes planus or pes planovalgus (ie, flatfoot) is a common condition among young children and also is encountered in adults. In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing act … Foot and Ankle Conditions: Pes Planus

How does congenital pes planus resolve with age?

In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing.

What is the rate of incidence of pes planus?

Pes planus or pes planovalgus, also known as flat foot, are both used to describe the same common condition that affects more than 30 percent of the population. However, it causes symptoms in only 1 in 10.

What are the conditions associated with rigid pes planus?

Other conditions associated with rigid pes planus include accessory navicular bone, congenital vertical talus or other congenital hindfoot pathology. [12] The spring ligament complex has been noted as an important stabiliser, but clarity still lacks in the literature.

What problems does pes planus cause?

In adults, pes planus may be an incidental finding. In symptomatic patients, there may be complaints of the midfoot, heel, lower leg, knee, hip, and or back pain. Patients with more advanced changes may complain of an altered gait pattern.

What causes pes planus deformity?

Etiology. 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. Dysfunction of the posterior tibial tendon(PTT) leads to pes planus of various degrees.

What happens when you have pes planus?

Pes planus (commonly referred to as 'flat feet') is a relatively common foot deformity and is defined by the loss of the medial longitudinal arch of the foot where it contacts or nearly contacts the ground. It can be flexible or rigid and it results in relative flattening of the plantar surface.

What is congenital flat foot?

Congenital flat foot is a condition of flat feet that is genetic, and many children are able to grow out of the inherited flatness of their feet. Other types of flat feet are not congenital and can be caused by a person's daily habits or activities.

Does pes planus go away?

The condition is referred to as pes planus, or fallen arches. It's normal in infants and usually disappears between ages 2 and 3 years old as the ligaments and tendons in the foot and leg tighten. Having flat feet as a child is rarely serious, but it can last through adulthood.

Can you be born with pes planus?

Congenital Pes Planus means a deformed foot present at or soon after birth in which the position of the bones relative to each other has been altered with the lowering of the longitudinal arch, i.e. hypermobile (flexible) flatfoot, and rigid flatfoot with tarsal anomalies.

Is flat feet considered a disability?

If a medical professional determines your condition was caused or aggravated by pes planus, you may qualify for disability benefits for the secondary service-connected condition. Proving secondary service connection for your flat feet-related disabilities can help you maximize your VA monthly compensation amount.

How does pes planus affect daily life?

Because flat feet cause your weight to be distributed abnormally, other joints and muscles take responsibility for keeping you upright. As a result, you may experience back and leg pain that can interfere with daily tasks, exercise, and activities you enjoy.

What does pes planus mean in medical terms?

Flat feet (pes planus) refer to a change in foot shape in which the foot does not have a normal arch when standing.

At what age can flat feet be corrected?

Most children outgrow the condition by age six. Even those who don't outgrow the condition (around 15 percent) rarely require treatment. If you think your child has flat feet, talk to his or her doctor.

Can genetic flat feet be fixed?

Typically, babies are born with flat feet. This condition, called “flexible flatfoot” begins to disappear when the child starts to stand and becomes mobile. In most cases, children outgrow this disorder without need for treatment, usually by the age six, as they start to naturally develop an arch.

Can flat feet be corrected as a child?

This could include shoe inserts to support the arch, physical therapy, special exercises, casting, or rarely, surgery. Kids with problems from flat feet usually need to see an orthopedic health care provider, who specializes in bones and joints.

Which muscle is responsible for pes planus?

This arch is supported by posterior tibial tendon, plantar calcanea navicular ligament, deltoid ligament, plantar aponeurosis, and flexor hallucis longus and brevis muscles. Dysfunction or injury to any of these structures may cause acquired pes planus.

How do you fix pes planus?

Flat feet (pes planus) are commonly known as fallen or collapsed arches....As you're working through these exercises, focus on raising, strengthening, and lengthening your arches.Heel stretches. ... Tennis/golf ball rolls. ... Arch lifts. ... Calf raises. ... Stair arch raises. ... Towel curls. ... Toe raises.

How do you fix flat foot deformity?

Cutting and shifting bones—Also called an osteotomy, this procedure consists of cutting and reconstructing bones in the foot to rebuild the arch. The heel bone and the midfoot are the most likely to be reshaped to achieve this desired result.

How can I improve my pes planus?

Counselling on proper footwear, recommendation on motion control shoes, orthotics and braces are also needed. Foot orthotics such as shoe inserts are used to support the arch for foot pain secondary to pes planus alone or combination with leg, knee, and back pain.

Treatment

If your child is quite young there may be no treatment needed for mild cases of flatfeet, especially flexible flatfeet. This condition often corrects itself in time as the child grows and develops. These children should be encouraged to walk barefoot whenever it is safe to do so as this will increase sensory input into the foot.

Surgery

Surgery is rarely needed for pes planus. Patients with severe, disabling symptoms that do not respond to conservative care may benefit from further orthopedic evaluation and treatment. In rare cases, surgical intervention to correct the problem and realign the foot may be suggested.

Post-surgical Rehabilitation

What should be expected with post-surgical recovery? Postoperative care will depend on the type of surgery that has been done. There will be a period of immobilization in a cast or removable boot following surgery for a tarsal coalition or an accessory navicular bone.

Prevalence

Previous studies indicate the prevalence of flatfoot between < 1% and 28% at certain age groups. Pes planus is more prevalent in children and females are more predisposed to this condition than their male counterparts in adulthood. There are about 20-30% of children with some form of flat feet.

Pathophysiology

The calcaneus, navicular, talus, first three cuneiforms, and the first three metatarsals make up the medial longitudinal arch. This arch is supported by posterior tibial tendon, plantar calcanea navicular ligament, deltoid ligament, plantar aponeurosis, and flexor hallucis longus and brevis muscles.

Associated Co-morbidities

Co-morbidities include but not limited to neurological conditions such as cerebral palsy; genetics e.g downs syndrome, Marfan syndrome or Ehlers Danos; charcot joint; tibialis posterior dysfunction; Obesity; arthropathies; Shprintzen-Goldberg syndrome.

Physical Therapy Management

The aim of Physical therapy is to minimize pain, increase foot flexibility, strengthen weak muscles, train proprioception, and patient education and reassurance.

Resources

Allen J, Solan S. Physiotherapy management of paediatric flat feet. Available from: https://www.peacocks.net/_filecache/316/436/892-physiotherapy-management-of-paediatric-flat-feet.pdf

Bringing Relief to Your Child's Flat Feet

Pes planus or pes planovalgus, also known as flat foot, are both used to describe the same common condition that affects more than 30 percent of the population. However, it causes symptoms in only 1 in 10.

Treatment Without Surgery

Your child will need treatment only if they have discomfort. Your Shriners Children's physician may recommend:

Surgical Care at Shriners Children's

If your child has pain that won't go away and worsens with activity, your Shriners Children's physician may recommend surgery. A team of highly skilled, experienced medical professionals is ready to help your child.

What Causes Pes Planus?

Pes planus occurs in almost 20% of the adult population. It is caused due to the loss of the medial longitudinal arch. It can be rigid or flexible. When the deformity is flexible, the alignment of the plantar arch can normalize.

What Are the Symptoms of Pes Planus?

Children with flexible flatfoot usually do not show any symptoms. Their shoes might wear out differently from normal people.

How to Diagnose Pes Planus

When the instep of the foot comes in contact with the ground, in standing position, they are suffering from Flat feet.

How to Treat Pes Planus

Adults are usually asked to wear footwear which is spacious, comfortable and has a good arch support.

What are the different types of flatfoot?

There are two general types of flatfoot: flexible flatfoot and rigid flatfoot. In flexible flatfoot, the foot has a normal arch at rest (not standing or walking ), but it disappears once it comes in contact with the ground. If there is no arch, whether sitting or standing, they have a "rigid" or "true" flatfoot.

Flatfoot Symptoms & Signs

A flatfoot may not cause symptoms or signs other than the change in the shape of the foot. When symptoms do occur, these can include

What are other causes of flatfoot?

As described above, a person may be born with a flatfoot, pediatric flexible flatfoot, or develop it as an adult (adult acquired flatfoot). Less common causes of flatfoot include the following:

What are flatfoot symptoms and signs?

A flatfoot may cause no symptoms. Symptoms of flatfoot include pain that may be in the inside arch, heel, or ankle and on the outside of the foot just below the ankle. Patients often complain of generalized foot fatigue as a first signs of flatfoot. Younger patients may complain their inability to keep up with their peers during physical activity.

How do health care professionals diagnose flatfoot?

One may look at their feet to see if they have an arch when standing barefoot for a general assessment. A foot specialist will provide an in-depth evaluation usually including X-rays to determine the precise type of flatfoot, its cause, and potential treatments.

What is the treatment for flatfoot?

Treatment depends on the type of flatfoot, its stage of progression, and the symptoms. Early treatment is advised whether one's condition is a flexible, rigid, or adult acquired flatfoot.

What is the prognosis of flatfoot?

Prognosis depends on the type and severity of the flatfoot. Many people with pediatric or flexible flatfoot function without any signs or symptoms and are unrestricted in their levels of activity. These people do perfectly well without any treatments. If there are symptoms, however, they are often successfully managed with conservative care.

2. Essentials of Assessment

Clinical assessment is important to determine the severity of the deformity and its reducibility 9. Majority of patients with PTT dysfunction describe a gradual onset of unilateral medial ankle and foot pain and deformity without clear history of trauma 9. Upon palpation, tenderness is along the PTT between medial malleolus and navicular bone 13.

3. Rehabilitation Management and Treatments

Initial treatment for all stages of PTT dysfunction includes various non-operative treatments including activity modification and nonsteroidal anti-inflammatory drugs (NSAIDs) 10. If patients continue to have pain after non-operative interventions or non-operative therapy for 3 to 4 months, then surgical intervention may be considered.

5. Gaps in the Evidence-Based Knowledge

New techniques of pain management include different types of foot orthotics and ankle bracing. The role of PRP, prolotherapy, botulinum toxin, percutaneous needle tenotomy, and stem cells needs to be evaluated. Considerable controversy remains about the appropriate treatment of all stages of PTT dysfunction.

Introduction

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Classification

Epidemiology

Clinically Relevant Anatomy

Pathophysiology

Characteristics/Clinical Presentation

Associated Co-Morbidities

Diagnostic Procedure

Medical Management

Physical Therapy Management