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Prevalence of flat foot in preschool-aged children
Martin Pfeiffer1, Rainer Kotz, Thomas Ledl
1Department of Orthopedics, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria. martin.pfeiffer@gmx.at
Insights
Flat foot prevalence in young children is high, decreasing with age. Overweight boys show the highest prevalence, and most treatments for flat foot in this age group are unnecessary.
Area of Science:
- Pediatric orthopedics
- Biomechanical analysis
- Public health
Background:
- Flat foot (pes planus) is common in children, but its prevalence and influencing factors require further investigation.
- Understanding the natural development of the foot arch is crucial for appropriate clinical management.
Purpose of the Study:
- To determine the prevalence of flat foot in 3- to 6-year-old children.
- To analyze the influence of age, weight, and gender on flat foot prevalence.
- To estimate the rate of unnecessary treatments for pediatric flat foot.
Main Methods:
- A cohort of 835 children (aged 3-6 years) was assessed.
- Clinical diagnosis involved heel valgus and arch formation assessment.
- Three-dimensional laser surface scanning was used to measure the rearfoot angle.
Main Results:
- Overall flexible flat foot prevalence was 44%, decreasing from 54% at age 3 to 24% at age 6.
- Boys (52%) had a higher prevalence than girls (36%).
- Overweight and obese children showed significantly higher flat foot prevalence compared to normal-weight children.
Conclusions:
- Flat foot prevalence in preschool children is significantly influenced by age, gender, and weight.
- Overweight boys exhibited the highest prevalence and potential delayed arch development.
- Over 90% of treatments for flat foot in this cohort were deemed unnecessary at the time of the study.
Objectives:
Our aim with this study was to establish the prevalence of flat foot in a population of 3- to 6-year-old children to evaluate cofactors such as age, weight, and gender and to estimate the number of unnecessary treatments performed.
Methods:
A total of 835 children (411 girls and 424 boys) were included in this study. The clinical diagnosis of flat foot was based on a valgus position of the heel and a poor formation of the arch. Feet of the children were scanned (while they were in a standing position) by using a laser surface scanner, and rearfoot angle was measured. Rearfoot angle was defined as the angle of the upper Achilles tendon and the distal extension of the rearfoot.
Results:
Prevalence of flexible flat foot in the group of 3- to 6-year-old children was 44%. Prevalence of pathological flat foot was < 1%. Ten percent of the children were wearing arch supports. The prevalence of flat foot decreases significantly with age: in the group of 3-year-old children 54% showed a flat foot, whereas in the group of 6-year-old children only 24% had a flat foot. Average rearfoot angle was 5.5 degrees of valgus. Boys had a significant greater tendency for flat foot than girls: the prevalence of flat foot in boys was 52% and 36% in girls. Thirteen percent of the children were overweight or obese. Significant differences in prevalence of flat foot between overweight, obese, and normal-weight children were observed.
Conclusions:
This study is the first to use a three-dimensional laser surface scanner to measure the rearfoot valgus in preschool-aged children. The data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. In overweight children and in boys, a highly significant prevalence of flat foot was observed; in addition, a retarded development of the medial arch in the boys was discovered. At the time of the study, > 90% of the treatments were unnecessary.
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