Clinical evaluation may reveal findings including, but not limited to, an everted or valgus-positioned heel, abduction of the forefoot relative to the rearfoot, collapse of the medial longitudinal arch, equinus deformity of the ankle, abductory twist within the forefoot during gait, and early heel rise during gait. The patient is examined non-weight bearing, weight bearing in stance, and during gait in order to fully appreciate the biomechanical and dynamic nature of the deformity. A thorough clinical examination is paramount in fully assessing the extent and various components of the deformity, and is at least as important as the radiographic evaluation. In fact, however, it is a complex deformity involving osseous, articular, and soft tissue pathology with both clinical and radiographic signs potentially evident in three cardinal body planes – transverse, sagittal, and frontal. Flatfoot deformity, also referred to as “pes valgus,” “pes plano valgus,” “pes planus,” or “peritalar subluxation,” is commonly characterized by a relatively simple and subjective “collapse” of the medial longitudinal arch of the foot ( Figure 1).
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