What's New in Pediatric Flatfoot?

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.