Radiologic changes of long term foot insole use in symptomatic pediatric flatfoot

Area of Science:

• Orthopedics
• Pediatric Podiatry
• Radiology

Background:

• Symptomatic flexible flatfoot (SFFF) is a common pediatric condition requiring treatment to prevent complications.
• Conservative management, particularly foot insoles, is the primary approach for SFFF.
• Objective radiographic measurements are needed to evaluate the efficacy of conservative treatments for SFFF.

Purpose of the Study:

• To assess the long-term effectiveness of foot insoles in improving radiographic indices in children with SFFF.
• To evaluate the impact of conservative treatment on calcaneal pitch angle (CPA) and talo-first metatarsal angle in pediatric flatfoot.
• To provide objective evidence for the benefits of foot insoles in managing SFFF.

Main Methods:

• Analysis of medical records of 292 children diagnosed with SFFF, with 200 selected for the study.
• Conservative treatment with periodically modified soft foot insoles and regular radiologic follow-ups (3-4 months).
• Measurement of calcaneal pitch angle (CPA) and talo-first metatarsal angle using lateral foot radiographs in a barefoot state.

Main Results:

• Significant improvement (P < .001) in both CPA and talo-first metatarsal angle after applying foot insoles.
• Radiographic improvements were observed across different age groups.
• The right foot CPA in the valgus deformity group showed no significant change (P = .078).

Conclusions:

• Periodically revised foot insoles are an effective conservative treatment for SFFF in children under 18.
• This treatment not only alleviates symptoms but also significantly improves key radiographic indices.
• Foot insoles represent a valuable non-surgical option for managing pediatric flatfoot.