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PES PLANUS (FLATFOOT) IN MALE AND FEMALE ADULTS OF BAYELSA- NIGERIA
Dare NW, Onyije FM, Osoma S.
Department of Human Anatomy, Faculty of Basic Medical Sciences,
College of Health Sciences, Niger Delta University,
Wilberforce Island. Nigeria
pastordarewn @ yahoo.com
Rev Electron Biomed / Electron J Biomed 2012;3:17-21.
Comment of the reviewer Prof. Dr. Alberto Enrique D'Ottavio, PhD. Catedrático de la Facultad de Ciencias Médicas, Investigador del Consejo de Investigaciones de la Universidad Nacional de Rosario. Rosario. Argentina
Comment of the reviewer Larisa Ivón Carrera PhD. Profesora e Investigadora, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Santa Fe (Argentina)
SUMMARY:
The aim of this research was to provide and document an accurate record of the noticeable occurrence of pes planus amongst adults in Bayelsa State (Nigeria).
A random sample of 510 persons (235 males and 275 females; aged 33 ± 15 years and totally Bayelsa's natives) was analyzed. An ink imprint on white paper of their weight-bearing surface of the feet was carried out with diagnostic purposes. 48 males (20.4%) and 81 females (29.5%) revealed pes planus whereas the rest of the sample did not show it. The incidence of pes planus was 1:4.
The well known frequent excess of bodyweight in these native groups may be responsible for this abnormality and obliges to pay due attention to the related habits. Furthermore, the obtained results could probably have anthropological and forensic medicine impact.
KEYWORDS:Pes planus, Males, Females, Adults, Bayelsa State.
RESUMEN:
Este trabajo intenta presentar un registro ajustado de la perceptible ocurrencia de pes planus en adultos del Estado de Bayelsa (Nigeria).
Una muestra aleatoria de 510 personas (235 hombres y 275 mujeres, con edad 33 ± 15 años y todos indígenas del estado) fue analizados. Una impresión en tinta sobre papel blanco de las plantas de sus pies fue usada con propósitos diagnósticos. 48 hombres (20.4%) y 81 mujeres (29.5%) revelaron pes planus mientras que el resto no lo hizo. La incidencia de tal patología fue 4:1.
El ya conocido y frecuente aumento de peso en estos grupos indígenas puede ser responsabilizado por esta anormalidad y fuerza a poner el acento en los hábitos relacionados con la obesidad. Además, se considera que los resultados obtenidos podrían poseer impacto antropológico y médico forense.
PALABRAS CLAVE: Pie plano, hombres, mujeres, adultos, Estado de Bayelsa
INTRODUCTION
Deformities of the fingers and toes are common conditions encountered by orthopedics and pediatricians in clinics. Some of these abnormalities are acquired, caused by traumatic injuries, neuromuscular pathologies, systemic diseases, or mechanical problems secondary to extrinsic pressures, while others are congenital1.
Pes planus (flat foot), defined as the postural appearance of the foot, with depressed medial longitudinal arch and a pronated subtalar joint and the calcaneous assuming a valgus position underweight bearing conditions, is the most common foot pathology not only in patients of all ages in general but in paediatric orthopaedic practice in particular1.
In this sense, it is about five times as frequent in children as cavus foot and is felt to be present in about one out of nine children 1. Far from Nigeria, it was reported that flat foot was found to be the most prevalent congenital abnormalities in Turkish school children aged 6-15 years2.
Children with flexible and painless flat feet do not require any treatment. Commonly asymptomatic, they are brought to the paediatricians by concerned parents because of the familiar layman perception that flatfoot will be associated with pain in adulthood. Conversely, it is imperative that rigid flat foot be evaluated to ascertain the presence of congenital vertical talus, tarsal coalition, or skew-foot, because all of these usually require surgical intervention3-5.
Pes planus becomes a musculoskeletal disorder of the feet in adolescents and adults resulting in a "fallen arch", particularly, the medial part of the longitudinal arches. In this foot pathology, the plantar calcaneo-navicular and long plantar ligaments appear abnormally stretched during long period of standing, traumatic injuries, systematic disease or mechanical problems secondary to extrinsic pressure. This may cause weakness or tearing of the plantar calcaneo-navicular ligament that supports the head of the talus, producing inferio-medial displacement of the head of the talus3-5.
Adults may develop painful flat feet after loss of posterior tibialis function6.
Experts in biomechanics and pathomechanics of the lower extremity understand the importance of subtalar joint pronation in association with midtarsal joint collapse, and the decreased stability effect in the proximal lower extremity joints (knee, hip, lower back). Functional foot orthoses can correct excessive pronation and may help with knee, hip or back pain. Custom functional foot orthoses that incorporate minimal cast fill, medial heel skive, and/or inversion can reposition the foot in a less pronated position. This correction may have either a preventive effect or a reversal effect on back or knee pain7.
Exceeding the relevance of an accurate diagnosis of pes planus during childhood and adolescents, this research aims to provide and document a reliable record on these studied patients taking into account the noticeable occurrence of pes planus amongst adults in Bayelsa State (Nigeria).
MATERIALS AND METHODS
A random sample of 510 adults (235 males and 275 females; aged 33 ± 15 years and totally Bayelsa's natives) were analyzed. An ink imprint on white paper of their weight-bearing surface of the feet was diagnostically carried out.
The current international ethical regulations were followed in this study.
Statistics: data were analyzed using unpaired t test, using Graph Pad Instat® software. P values < 0.05 were considered significant.
RESULTS.
As seen in Table 1, 48 males (20.4%) and 81 females (29.5%) (i.e: 129 patients - 25.3% -) revealed pes planus whereas the rest of the sample did not show it. Within the age groups, those aged between 18 and 22 put into evidence the higher percentage of pes planus in both sexes. However, no significant differences (p > 0.05) were detected between sexes in the studied sample.
In Table 2, a comparison of the Prevalence of Pes planus in different populations of the world including Bayelsa State (Nigeria) was achieved. Data related with Bayelsa (Nigeria) are high.
DISCUSSION:
In accordance with the results obtained in the random sample here studied and reported in Tables 1 and 2 the percentage of persons affected by pes planus (flat foot) in Bayelsa State was 25.3% (ratio 4:1). This percentage acquires relevance because of its compatibility with the prevalence (25% -13% in males and 12% in females-) recorded in a study carried out among school children8. It also agrees with other communication where the incidence of pes planus was 242.6/1000 (24.26%) using the arch index method9 as well as with data reported in Israel 28.82% (17% in males and 11.65% in females)12. Conversely, there exists reports with lower data as those carried out among school children in Port Harcourt where unilateral pes planus was 2.22 % and bilateral ones 0.6%10 and other performed in Akwa Ibom (11.2%)11.
Concerning gender, the results here stated with no significant differences between sexes but higher in females harmonize with supported by Ndife (1998) revealing that females are more prone to pes planus 13 and contradicts others where males prevail over females in this regard12,14.
The well known frequent excess of bodyweight in these native groups resulting of a different way of life including fast foods, reduction in movement and spotting activity and inappropriate foot may be responsible for this increasing abnormality and obliges to pay due attention to the related habits. In this regard, in Nigerian Yoruba tribe flexible flat foot prevails in males who are obese, particularly in those aged 7-8 8.
To sum up, it is here revealed that one out of every four adult Bayelsans has pes planus, Its potential relevance for anthropology and forensic medicine lead us to suggest subsequent further studies to classify various types of pes planus since it could be used for classifying humans from different regions.-
REFERENCES
1. Lee, M. Diagnosis and Treatment of Adult Flatfoot. J Foot Ankle Surg. 2005; 44 :78-113
2. Yucesan SH, Dindar I, Olcay H et al. Prevalence of congenital abnormalities in Turkish school children. Eur. J. Epidemiol. 1993; 9: 373-380
3. Kim HW, Weinstein SL. Flatfoot in children: Differential diagnosis and management. Curr Orthop. 2000; 14:441-447
4. Bresnahan P. Flatfoot deformity pathogenesis. Atrilogy. Clin Pediatr Med Surg. 2000; 17:505-512
5. Van Boerum DH, Sangeorzan BJ. Biomechanics and pathophysiology of flat foot. Foot Ankle Clin 2003; 8:419-430
6. Rose REC. Flat feet in Children: When should they be treated? Internet J Orthop Surg. 2007 5: 1
7. Kosashvili Y, Fridman T, Backstein D. The correlation between pesplanus and anterior knee or intermittent low back pain. Foot Ankle Int. 2008; 29:910-913
8. Umar MBT, Adeyemi P. Incidence of Flat Foot and Anthropometric Comparison between Flat and Normal Foot of the Yoruba Ehtnic Group of Nigeria. Res J Appl Sc. 2010; 5: 6, 412-416.
9. Igbigbi PS, Msamati BC. The footprint ratio as a predictor of pes planus: a study of indigenous Malawians. J Foot Ankle Surg. 2002; 41: 394-397
10. Didia B C, Asomugha AL. The incidence of flatfoot amongst athletes in Port Harcourt. J Exp Clin Anat; 2004; 3: 58-59
11. Eluwa MA, Omini RB, Kpela T, et al. The Incidence of Pes Planus Amongst AkwaIbom State Students In The University Of Calabar. The Internet J of Forensic Sc. 2009; 3; 2 (Available in http://www.ispub.com/journal/the-internet-journal-of-forensic-science)
12. Lakstein D, Fridman T, Ziv YB, Kosashvili Y. Prevalence of anterior knee pain and pesplanus in Israel defense force recruits. Mil Med. 2010;175:855-857
13. Ndife J. Epidemiological survey of foot problems in a predominantly subsistence farming community. African J of Ecology 1998; 36:2-5
14. Chang JH, Wang SH, KuoCL, Shen HC, Hong YW, Lin LC. Prevalence of flexible flat foot in Taiwanese School aged children in relation to obesity, gender and age. Eur J. Pediatrics, 2010; 169:447-452
15. Eluwa MA, Omini RB, Akpantah AO, Ekanem TB. Incidence of Pes planus amongst the people of Cross River State Global Journal of Medical Sciences 2008; 7, 1-2
16. Ukoha UU, Egwu OA, Okafor IJ, Ogugua PC, Igwenagu VU. Pes Planus: Incidence Among An Adult Population In Anambra State, Southeast Nigeria. Int J Biomed Adv Res 2012; 3:3 (Available in http://www.ssjournals.com/index.php/ijbar/article/view/286)
17. Cetin A, Sevil S, Karaoglu L, Yucekaya B. Prevalence of flat foot among elementary school students, in rural and urban areas and at suburbs in Anatolia. Eur J Orthop Surg Traumatol 2011; 21: 5: 327-331
18. Igbigbi PS, Msamati BC, Shariff MB. Arch index as a predictor of pesplanus: a comparative study of indigenous Kenyans and Tanzanians. J Am Pediatr Med Assoc. 2005; 95:273-276
CORRESPONDENCE:
Nervey W. Dare
Department of Human Anatomy,
Faculty of Basic Medical Sciences, College of Health Sciences,
Niger Delta University,
Wilberforce Island
Mail: pastordarewn @ yahoo.com