Introduction:
Unilateral secondary flat-foot in children is unusual, and in the absence of a major trauma history should raise suspicion of a neuromuscular etiology. Flatfoot from tibialis posterior tendon (TPT) rupture in children is very rare.
Case report:
A 10-year-old girl presented with unilateral flatfoot and unusual shoe wear of few years duration. A TPT rupture was diagnosed. After observing a 3-4 mm superficial scar behind medial malleolus, and after a lot of questioning, her mother remembered an abrasion she had sustained 6 years ago playing in a park.She was successfully treated by flexor hallucis longus (FHL) tendon transfer and obtained and maintained a nice longitudinal arch.
Conclusion:
TPT rupture in children may happen by a minor laceration or trauma and be only recognized after developing flatfoot. FHL tendon transfer can restore the arch even in late cases.