Paediatric Flatfoot

Causes

Symptoms

Flatfoot can be apparent at birth or it may not show up until years later. Most children with flatfoot have no symptoms, but some have one or more of the following symptoms:

• Pain, tenderness, or cramping in the foot, leg, and knee.
• Outward tilting of the heel.
• Awkwardness or changes in walking.
• Difficulty with shoes.
• Reduced energy when participating in physical activities.
• Voluntary withdrawal from physical activities.

Diagnosis

In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when the child stands and sits. The surgeon also observes how the child walks and evaluates the range of motion of the foot. Because flatfoot is sometimes related to problems in the leg, the surgeon may also examine the knee and hip. X-rays are often taken to determine the severity of the deformity.

Non-surgical Treatment

When the child has symptoms, treatment is required. The foot and ankle surgeon may select one or more of the following non-surgical approaches:

• Activity modifications. 
• Orthotic devices. 
• Physical therapy. 
• Medications.
• Shoe modifications. 

When is Surgery Needed?

In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when the child stands and sits. The surgeon also observes how the child walks and evaluates the range of motion of the foot. Because flatfoot is sometimes related to problems in the leg, the surgeon may also examine the knee and hip. X-rays are often taken to determine the severity of the deformity.