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Plantar pressures in symptomatic and asymptomatic flexible flatfeet: how do they differ?
Victoria Blackwood1, Kelly A Jeans1, Rusty L Hartman1
1Scottish Rite for Children, Dallas, Texas.
Adolescents with symptomatic flexible flatfoot show distinct pedobarographic differences, particularly in the medial midfoot, compared to asymptomatic cases. However, these differences did not predict surgical versus non-surgical outcomes.
Area of Science:
- Orthopedics
- Biomechanics
- Pediatrics
Background:
- Flexible flatfoot in adolescents often lacks correlation between clinical/radiographic measures and pain.
- The reasons for symptomatic versus asymptomatic flexible flatfoot remain unclear.
- Pedobarography may offer insights into biomechanical differences.
Purpose of the Study:
- To compare pedobarographic parameters between symptomatic flexible flatfoot (SFF) and asymptomatic flatfeet (AFF) in adolescents.
- To identify biomechanical factors contributing to symptomatic flexible flatfoot.
- To evaluate differences between operative and nonoperative management in SFF.
Main Methods:
- Retrospective review of a Foot and Ankle registry.
- Plantar pressure analysis (contact area, contact time, mean force) in SFF and AFF groups.
- Assessment of patient-reported outcomes using the Oxford Ankle Foot Measure (OxAFM).
Main Results:
- Symptomatic flexible flatfoot (SFF) demonstrated significant differences in all pedobarographic variables compared to asymptomatic flatfeet (AFF) and controls, especially in the medial midfoot.
- No significant pedobarographic differences were observed between SFF patients who underwent surgery versus those managed nonoperatively.
- The surgical group reported poorer outcomes on the Oxford Ankle Foot Measure (OxAFM) for school/play and emotional wellbeing.
Conclusions:
- Adolescents with symptomatic flexible flatfoot exhibit a medial shift in weight distribution compared to asymptomatic individuals.
- Pedobarographic findings did not differentiate between surgical and conservative treatment success in symptomatic flexible flatfoot.
- Further research is needed to understand the etiology of symptomatic flexible flatfoot and guide treatment decisions.
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