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Todd Borenstein MD

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Flatfeet in Children

What is pediatric flatfoot deformity?

Most children are born with flatfeet and develop the longitudinal arch of the foot between 3 and 5 years of age. However, in some children the arch does not develop, and remains collapsed. Flatfeet can be flexible or rigid. Flexible flatfeet are usually not serious and resolve without treatment. Flexible flatfeet associated with pain and rigid flatfeet should be evaluated.

What causes pediatric flatfoot deformity?

Pediatric flatfeet are a common condition with multiple causes. They can be inherited, a result of loose ligaments, muscle weakness, tight Achilles tendons and rarely from an abnormal fusion of bones in the foot called tarsal coalitions.

What are the symptoms of adult acquired flatfoot deformity?

Pediatric flatfeet are a common condition with multiple causes. They can be inherited, a result of loose ligaments, muscle weakness, tight Achilles tendons and rarely from an abnormal fusion of bones in the foot called tarsal coalitions.

What are the symptoms of pediatric flatfoot deformity?

Many children with pediatric flatfeet have no symptoms. These do not require treatment. When flatfeet are symptomatic, children may feel pain in the arch, foot, heel, and leg. They may also have discomfort wearing shoes, and complain of fatigue and achiness in the feet with prolonged standing.

How is pediatric flatfoot deformity diagnosed?

The diagnosis of pediatric flatfoot deformity begins with a thorough physical examination. Warning signs are checked for including calf tightness, a rigid flatfoot, and pain and weakness in the foot and ankle. If any warning signs are present such as foot pain or an arch that does not form with sitting, X-rays will be ordered. A computed tomography (CT) scan and magnetic resonance imaging (MRI) may also be ordered to further evaluate for tarsal coalitions.

How is pediatric flatfoot deformity treated?

Nonsurgical treatment

If the condition is not painful, that flatfeet may be simply observed for changes over time. However, if the flatfeet are associated with symptoms, custom orthotics to support the arch, physical therapy to stretch the calf and Achilles tendon, shoe modifications, and avoiding exacerbating activities such as sports may be recommended.

Surgical

Surgical intervention is rarely needed for pediatric flatfeet. If symptoms persist despite conservative treatment, then surgery may be necessary. There are various surgical procedures for the treatment of pediatric flatfeet depending on your child’s specific condition. These include tendon lengthening, reconstructing the arch, removing abnormal bones and fusing bones.