Bone anomalies of the tarsus in relation to peroneal spastic flat foot.

Harris and Beath (1947) made a valuable contribution to surgery when they described for the first time the developmental anomaly at the sustentaculum tali-the talo-calcanean bridge-as an important and frequent element in the production of rigid flat foot. They also performed a further service by drawing attention to the hitherto rather neglected pa pers of Slomann (1921) and Badgley (1927). Both these authors described another congenital anomaly -the calcaneo-navicular bar-in association with so-called spastic flat foot, but their work went practically unheeded by their surgical colleagues. Seven years ago the etiology of peroneal spasm and rigid flat foot was still something of a mystery. Treatment was mainly empirical and usually unsuccessful. The fact that special radiological projections are required in order to reveal the anomalies is probably the reason for their prolonged obscurity. In consequence of the stimulation of Harris and Beath’s contribution, all patients with peroneal spasm or rigid flat foot, excluding those with rheumatoid arthritis, seen since 1949 have been made the subject of special study. This paper presents an analysis and discussion of the main features in thirty patients, twenty-seven of whom reported with the usual symptoms and signs. Three others reported for other reasons and, in the course of routine examination, were found to possess one or other of the bone anomalies. They have been included in order to further knowledge of the behaviour of these anomalies. For the sake of convenience the short descriptive terms suggested for these anomalies by Harris and Beath --the talo-calcanean bridge and the calcaneo-navicular bar-will be used throughout. Since Harris and Beath’s paper, a report has been published by Webster and Roberts (1951) on twenty-one patients with peroneal spasm or rigid flat feet, of whom tarsal anomalies were found in fourteen. TABLE I