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. 2013 Jun;23(3):247-60.

Pediatric flexible flatfoot; clinical aspects and algorithmic approach

Farzin Halabchi  1 , Reza Mazaheri, Maryam Mirshahi, Ladan Abbasian
Affiliations

Pediatric flexible flatfoot; clinical aspects and algorithmic approach

Farzin Halabchi et al. Iran J Pediatr. 2013 Jun.

Abstract

Flatfoot constitutes the major cause of clinic visits for pediatric foot problems. The reported prevalence of flatfoot varies widely due to numerous factors. It can be divided into flexible and rigid flatfoot. Diagnosis and management of pediatric flatfoot has long been the matter of controversy. Common assessment tools include visual inspection, anthropometric values, footprint parameters and radiographic evaluation. Most flexible flatfeet are physiologic, asymptomatic, and require no treatment. Otherwise, the physician should treat symptomatic flexible flatfeet. Initial treatment options include activity modification, proper shoe and orthoses, exercises and medication. Furthermore, comorbidities such as obesity and ligamenous laxity should be identified and managed, if applicable. When all nonsurgical treatment options faile, surgery can be considered. Our purpose in this article is to present a clinical algorithmic approach to pediatric flatfoot.

Keywords: Algorithm; Children; Exercise; Flatfoot; Hyperpronation; Orthosis; Pes planus.

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Figures

Fig. 1
Fig. 1
Footprint analysis, a)Arch index, A-forefoof, B-midfoot, C-hindfoot, L- length of the foot. Arch index= B/A + B+C; b)Chippaux-Smirak index= B/A × 100% c) Staheli arch index= B/C × 100%
Fig. 2
Fig. 2
Lateral radiograph of foot TM, talo-first metatarsal angle; TH, talo-horizontal angle; TC, talocalcaneal angle; CA, calcaneal inclination angle
Fig. 3
Fig. 3
Diagnostic algorithm for pediatric flatfoot
Fig. 4
Fig. 4
Algorithmic approach to pediatric flatfoot
See this image and copyright information in PMC

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