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What is a symptomatic flexible flatfoot in children? A systematic review on its definition
Maurizio De Pellegrin1, Lorenzo Marcucci2, Anja Helmers3
1Pediatric Orthopedic Unit, Piccole Figlie Hospital, Parma, Italy; Department of Orthopedics, ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Background:
The definition of symptomatic FFF in children is still unclear. The aim of this review was to summarize the literature regarding the definition of "symptomatic" considering also new diagnostic tools recently available.
Methods:
A systematic search was conducted according to PRISMA using PubMed, Cochrane Library and Scopus databases for the terms: "symptomatic flat foot and children". Reported symptoms at clinical examination and evaluation methods were extracted.
Results:
A total of 15 different symptoms were reported: pain (n = 24), dysfunction (n = 16), functional impairment (n = 8), reduced quality of life (n = 6), altered kinetic chain (n = 5), daily activities limitation (n = 5), fatigue (n = 4), sport limitation (n = 3), skin lesions (n = 3), general pain and fatigue (n = 3), tight Achilles tendon (n = 2), gait abnormalities (n = 2), others (n = 3). Eleven reported new different diagnostic tools: gait analysis (n = 7), pedobarography (n = 3), podoscopy (n = 2).
Conclusions:
Beyond pain, fourteen additional clinical features have been described. FFF should therefore not be considered symptomatic solely based on presence of pain.
Level Of Evidence:
II.
