Related Experiment Video
Updated: Apr 5, 2026
Evaluating the Function of the Foot Core System in the Elderly
Published on: March 11, 2022
What's New in Pediatric Flatfoot?
Kathryn Bauer1, Vincent S Mosca, Lewis E Zionts
1*Department of Orthopaedics, David Geffen School of Medicine at UCLA, Orthopaedic Institute for Children, Los Angeles, CA †Department of Orthopaedics and Sports Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
Insights
Pediatric flatfoot often requires no treatment, but rigid deformities like congenital vertical talus or tarsal coalition need careful evaluation. Evidence for treating flexible flatfoot is limited, while new methods for congenital vertical talus show promise.
Area of Science:
- Pediatric Orthopaedics
- Foot and Ankle Surgery
- Biomechanical Engineering
Background:
- Pediatric flatfoot is a common referral to orthopaedic clinics, with most cases being asymptomatic and not requiring intervention.
- Distinguishing flexible flatfeet from rigid deformities is crucial, as rigid cases may indicate underlying pathology.
- Rigid flatfeet in infants can be congenital vertical talus (CVT), while in older children, tarsal coalition is a common cause.
Purpose of the Study:
- To review recent literature on the evaluation and management of pediatric flatfeet.
- To discuss new findings and identify areas for future research in pediatric flatfoot conditions.
Main Methods:
- A literature review was conducted using the PubMed database.
- Searched for papers on pediatric flatfoot, tarsal coalition, and CVT published between January 1, 2011, and December 31, 2014.
- Included 85 English-language papers, with 18 contributing significant findings.
Main Results:
- The pediatric flexible flatfoot (FFF) is poorly defined, complicating its study and treatment.
- There is limited evidence supporting the efficacy of nonsurgical interventions for FFF in altering foot shape or preventing long-term disability.
- Tarsal coalition treatment shows satisfactory short-to-intermediate term outcomes, but long-term data is lacking.
Conclusions:
- Pediatric flexible flatfoot is frequently overtreated, with insufficient evidence for nonsurgical treatment benefits.
- Management of tarsal coalition is challenging; long-term outcome studies are needed, and addressing the associated flatfoot deformity is important.
- The management of congenital vertical talus (CVT) is evolving, with promising early results from less invasive treatments.
Background:
Children with flatfeet are frequently referred to pediatric orthopaedic clinics. Most of these patients are asymptomatic and require no treatment. Care must be taken to differentiate patients with flexible flatfeet from those with rigid deformity that may have underlying pathology and have need of treatment. Rigid flatfeet in infants may be attributable to a congenital vertical talus (CVT); whereas those in older children and adolescents may be due to an underlying tarsal coalition. We performed a review of the recent literature regarding evaluation and management of pediatric flatfeet to discuss new findings and suggest areas where further research is needed.
Methods:
We searched the PubMed database for all papers related to the treatment of pediatric flatfoot, tarsal coalition, and CVT published from January 1, 2011 to December 31, 2014, yielding 85 English language papers.
Results:
A total of 18 papers contributed new or interesting findings.
Conclusions:
The pediatric flexible flatfoot (FFF) remains poorly defined, making the understanding, study, and treatment of the condition extremely difficult.Pediatric FFF is often unnecessarily treated. There is very little evidence for the efficacy of nonsurgical intervention to affect the shape of the foot or to influence potential long-term disability for children with FFF. The treatment of tarsal coalition remains challenging, but short-term and intermediate-term outcome studies are satisfactory, whereas long-term outcome studies are lacking. Management of the associated flatfoot deformity may be as important as management of the coalition itself. The management of CVT is still evolving; however, early results of less invasive treatment methods seem promising.
Level Of Evidence:
Level 4-literature review.
Related Concept Videos
01:10Ankle Joint
01:28Muscles of the Leg that Move the Foot and Toes
Anterior Compartment
The anterior compartment includes muscles that contribute to the dorsiflexion of the foot. This compartment houses the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles....
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:10Bones of the Lower Limb: Tibia and Fibula