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Flatfoot in children  |




Flatfoot is the reduction in height or even the elimination of the arch of the foot with contemporary valgus of the heel. Normally, the arch of the foot begins to develop after the age of 12-18 months, after the infant begins to walk and is completed around 5-6 years.
It is natural for the arch of the foot to be reduced during this period, which is why only if it is accompanied by heel valgus, this finding is evaluated.



The normal laxity of the foot joints reaches its peak in children between 2 and 3 years of age and then gradually subsides. By age 2, nearly 97% of normal children have some degree of flat feet. By the age of 10, only 4% remain flat-footed. The effect of the shoe on the development of the foot is questionable because the examination of large population groups of primitive tribes, compared to peoples who wear shoes, gave almost identical rates of flat feet.



Platypodia is distinguished into:
- Loose Flatfoot: It is usually bilateral and is usually due to laxity of the ligaments of the end of the foot. It is less often observed in external rotation of the legs, in valvular knees, short Achilles tendon, etc.
- Stiff Flatfoot: The patient (except in the case of vertical ankle), is usually a teenager or an older person and complains mainly of pain and stiffness in the feet. The causes can be distinguished into congenital and acquired.












The acquisitions include:
1, Intra-articular fractures of the heel or ankle
2, Inflammations of the ankle joint (tuberculous, rheumatic, etc.)


Children usually do not complain of pain or other discomfort. Parents, however, usually report that their children show fatigue easily, frequent falls and a somewhat awkward and unsteady gait, compared to their healthy children of the same age. They also report rapid wear and deformation of the footwear.
The infant foot has fatty tissue under its arch. When the child begins to walk, the arch may appear but disappears when the foot is loaded.



Clinical Picture:

  • Falling of the longitudinal arch, especially on loading, i.e. when standing

  • Resurfacing the arch with the foot in a non-loading position

  • Protrusion or not of the head of the ankle towards the medial side of the foot

  • Abduction of the forefoot from the ankle joint

  • Vulnerability of the heel

  • Showing a short Achilles tendon




Clinical examination:

The foot arch does not exist at birth, it develops dynamically and takes its final form around the age of 5. The maturing of the sole and by extension the foot takes place around the age of 14-15 years (earlier in girls).

Radiological study: In asymptomatic children an X-ray is rarely requested, but in symptomatic children a lateral and anteroposterior X-ray of the legs in support should be done.

Treatment: depending on the degree of deformity and the philosophy of the podiatrist, the patient and his environment, we have different types of treatment, conservative and surgical.













 Conservative treatment:
Its aim is to prevent worsening of the deformity, while at the same time permanent correction must be achieved. Typically this is achieved by applying some arch support.



Mild to moderate cases of lax flatfoot are painless and do not require special treatment. When heel valance exceeds moderate, the application of orthopedic shoes with the heel raised from the medial part by approximately 3 mm along with modern arch strengthening helps to correct the position of the foot and its proper development. (special flat feet are not recommended).


Avoid the child walking barefoot on the floor and encourage him to walk barefoot on the beach in the summer.




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