Non-surgical interventions for paediatric pes planus

Area of Science:

• Pediatrics
• Orthopedics
• Sports Medicine

Background:

• Paediatric pes planus (flat feet) affects 14% of children, potentially causing pain and gait alterations.
• Current non-surgical management strategies for paediatric flat feet lack a defined optimal approach.
• Understanding effective treatments is crucial for improving pediatric foot health and function.

Purpose of the Study:

• To systematically evaluate the efficacy of non-surgical interventions for paediatric pes planus (flat feet).
• To identify evidence-based treatments for pain reduction and functional improvement in children with flat feet.

Main Methods:

• Conducted a comprehensive literature search of multiple databases (e.g., CENTRAL, MEDLINE, EMBASE) up to June 2009.
• Included randomized and quasi-randomized trials assessing non-surgical interventions for paediatric flat feet.
• Primary outcomes focused on pain reduction and adverse events; secondary outcomes included foot function, quality of life, and comfort.

Main Results:

• Three trials with 305 children were included; data heterogeneity precluded pooling.
• Custom-made orthoses showed a significant pain reduction (VAS: -1.5) and disability improvement (FFI: -18.65mm) compared to supportive shoes in one trial (40 children).
• Other trials found no significant difference in pain reduction with custom vs. prefabricated orthoses or no treatment, and limited data on subjective pain in younger children; no adverse effects were reported.

Conclusions:

• Current evidence from randomized controlled trials is insufficient to definitively conclude the effectiveness of non-surgical interventions for paediatric pes planus.
• High-quality future trials are necessary to guide the management of symptomatic and asymptomatic flat feet in children.
• Limited commonly used interventions have been rigorously studied, highlighting a gap in evidence-based practice.