[Flexible flatfoot in children--a controversial subject]

In this review article authors present current opinion on flexible flatfeet in children. In young generation the incidence of flexible flatfeet is different according to investigator and evaluation method and ranges from 3 to 90 percent. The high percentage of appearance of flatfeet in healthy population is recognized mainly by investigators who are not orthopaedic surgeons. The flexible flat foot in children can be divided on developmental and static. The first one is visible in children immediately after starting walking and disappears spontaneously. The second one is associated with generalized but not pathologic soft tissue laxity. It is confirmed, that both do not need treatment. Nevertheless, the tendency for over-treatment of deformity by exercises, inserts and special shoes is observed. This kind of treatment results in costs and low effectiveness as well as psychological problems in patients. Persistent deformity does not cause worse quality of life in adulthood. Flexible flatfeet can be associated with shortening of the gastrocnemius muscle or even Achilles tendon. It results in valgus deformity of the hindfoot as compensation for the lack of dorsal flexion of the foot in the ankle joint. This deformity can be treated surgically.