Overview and Treatment for A Flatfoot in Children

Abstract

Although the exact incidence of flatfoot in children is unknown, it is a common finding. All children have only minimal arch at birth, and more than 30% of infants have calcaneovalgus deformities in both feet. The condition is painless and usually clears up on its own without treatment; It is very rarely necessary to cast correction. Most children who visit an orthopedist for an evaluation for flatfoot will have flexible flatfoot without treatment. However, the examining physician must rule out other conditions that require treatment, such as congenital longitudinal defects, dorsal alignment, and misaligned feet. Left untreated, congenital vertical nails can lead to an awkward gait; Manipulation and casting have been tried, but most authors now agree that surgical treatment is necessary. Although dorsal alignment may be asymptomatic in adulthood, the anatomy will never be normal. Excision and interlacing of the digital extender or perforation is the treatment of choice for pelvic fusions; The outcome of talocalcaneal union treatment is less predictable. Skewfoot should be treated with manipulation and serial casting as soon as discovered. In older children, it may be necessary to stabilize the hindfoot and realign the midfoot. Surgical management is rarely indicated for true soft flat feet. Many tendon transfer methods and reconstructive procedures have been advocated, but none have been shown to be equally successful. Nor is there any kind of support that has been shown to alter arch architecture. Although parents are often concerned about flat feet in their children, children often have no symptoms and no indication for treatment. In most cases, the best treatment is simply taking enough time to convince the family that no treatment is needed.