Pediatric peroneal spastic flatfoot in the absence of coalition. A suggested protocol

While most pediatric patients with peroneal spastic flatfoot demonstrate tarsal coalitions, not all do. The absence of coalition may present a diagnostic challenge and make appropriate treatment difficult. Past and present etiologic theories, diagnostic modalities, and treatments are outlined in this article. The common peroneal nerve block is of great value in the diagnosis and treatment of peroneal spastic flatfoot with or without coalition. With adjunctive treatments, increased motion and decreased symptomatology are often obtained. A protocol, applied to five cases described herein, is suggested.