PES PLANUS IN PATIENTS WITH POSTERIOR TIBIAL TENDON INSUFFICIENCY - ASYMPTOMATIC VERSUS SYMPTOMATIC FOOT

Bilateral weightbearing anteroposterior and lateral radiographs were a nalyzed in 43 patients with a clinical diagnosis of posterior tibial t endon insufficiency by two independent observers. The radiographs of e ach patient's asymptomatic foot was considered to serve as the control for the preexistance of pes planus. The radiographs were assessed for the severity of flatfoot deformity, the degree of talonavicular cover age, the talometatarsal angle, the calcaneometatarsal angle, the cunei form to ground height and the cuneiform to fifth metatarsal height. In terobserver correlatations were assessed. Results indicated that there was a high interobserver correlation for the values measured, making these angles reproducible among observers. Strong correlations were fo und in the degree of severity of flatfoot deformity between the asympt omatic and symptomatic feet as well as the values used to assess pes p lanus (i.e., similar radiographic measurements on the opposite side). The data suggest that patients with posterior tibial tendon insufficie ncy often have a preexisting flatfoot. This substantiates our belief t hat a preexisting flexible flatfoot, although far from the determining factor, is one of several etiological factors in the development of p osterior tibial tendon insufficiency.