Purpose: to assess the subjective perception of flatfoots prevalence in children, its age dynamics and the main approaches to the diagnosis and treatment by doctors of various pediatric specialties with different medical experience and working in medical facilities at various levels by anonymous questionnaire. Materials and methods. Questionnaire data from 80 orthopedists (50 outpatient doctors, 30 doctors from a specialized scientific research institute and orthopedic departments of city hospitals (research institutes / hospitals) and 30 neurologists (polyclinic). Results: our study demonstrated that outpatient orthopedists diagnose the flatfoot on average in half of the cases. The orthopedists diagnose flatfoot only by means of visual examination in 46.1% of cases (neurologists in 85.7% of cases). According to our data, 58.9 % of outpatient doctors recommend wearing special orthopedic shoes (46.1 % only if the foot alone is affected) and 95.1 % of specialists recommend wearing individual orthopedic insoles (53.6 % if there are complaints). While 88.2 % of the orthopedic surgeons from specialized research institutes and hospitals do not recommend wearing orthopedic shoes; 26.7 % of experts recommend wearing individual orthopedic insoles only in the presence of complaints. On the other hand, the neurologists recommend wearing orthopedic shoes 5.3 times more often than the orthopedists do. Conclusion: our study demonstrates that the specialty of the doctor (orthopedist, neurologist) and the type of health care facilities in which the specialist works have the greatest impact on his subjective perception of the prevalence and age dynamics of flatfoot in children, tactics of diagnostics and treatment. The outpatient orthopedists diagnose flatfoot 4.2 times more often than the orthopedic surgeons from the specialized research institute and hospitals. Also, the outpatient orthopedists prescribe wearing orthopedic shoes 4.9 times more often (insoles 3.6 times more often) in comparison with the orthopedic surgeons of the specialized research institute and orthopedic hospitals. Summarizing the above mentioned, we would like to note that due to the fact that the current assessment of the age limits of the arch height feet is ambiguous, there is a need to introduce a unified system for assessing the foots shape and posture with defining the concepts of average height and typically developing foot.

Background. The visual assessment of flatfoot is the most commonly used method by pediatric orthopedists. It is necessary to confirm good consistency among specialists to justify its use as a standard. Aim. The aim of this study was to determine the consistency of visual assessment of flatfoot among orthopedists. Materials and methods. The first stage of this study included 187 primary school-aged children. The main methods used were clinical examination and computer plantography. Then, 130 images of the right foot were randomly selected in standard projections medial and posterior, which were provided to 32 orthopedists (ten of whom were experts). Specialists needed to note whether the foot presented for analysis was flat. We used the w-Kendall concordance coefficient and -Kendall correlation coefficient to determine the inter-rater reliability. After five months, the intra-rater reliability was determined, and the Cohen coefficient was calculated. Results. Our study demonstrated that the inter-rater reliability varied significantly depending on whether the orthopedist specialized in foot pathology. When calculating the concordance coefficient, an increase in the consistency among experts was noted after five months (0.58 and 0.76, respectively), compared with orthopedists who do not specialize in foot pathology. Although some heterogeneity was noted according to experts on the same foot, the overall correlation coefficient corresponded to a good and excellent level of consistency (0.650.84). Cohens coefficient among specialists corresponded to a good level of confidence (0.72), whereas among orthopedists who do not specialize in foot pathology, there was a low level of confidence (0.31). According to experts, the frequency of flatfoot was 24.6%, whereas according to orthopedists who do not specialize in foot pathology, it was 40.9% when they evaluated images of the same feet. Conclusion. Experts answers regarding which foot should be considered flat demonstrated a good and excellent level of consistency. Therefore, they can be used to determine reference values of anthropometric parameters of the medial foot arch.

BACKGROUND: To date, there is no consensus regarding the diagnostics of flatfoot in children and approaches to its classification and treatment. AIM: This study aimed to demonstrate the results of the first Russian consensus, performed according to the Delphi method, for the diagnostics and treatment of flatfoot in children. MATERIALS AND METHODS: The study was conducted in accordance with the principles of the Delphi survey and the RAND/UCLA and participated by 22 experts in their field. The questionnaire consisted of four main sections, namely, general clinical assessment, flatfoot diagnosis, classification approach, and treatment, including 179 close-ended and 11 open-ended statements in both rounds. A 5-point Likert scale was used to rank responses. The level of agreement was determined as follows: 70% of the experts agrees, the statement is accepted; 55%, rejected; 55%69%, reassessment by experts in subsequent rounds. To assess agreement among experts, parameters such as general agreement, agreement without doubt by experts, and percentage of doubting experts were calculated. Mean (M), standard deviation (SD), and Cronbachs alpha were calculated. RESULTS: The statement was accepted with an agreement without doubt by experts 70%, with Cronbachs alpha of 0.8. According to the survey data, in the two rounds using 179 close-ended statements, 96 statements were accepted, 63 were rejected, and no consensus was reached on 20. CONCLUSIONS: This scientific work presents the results of the first Russian Delphi survey on the diagnosis and treatment of flatfoot in children with a unique number of experts (n = 22). The lack of agreement on some of the statements, even among experts, showed that consensus was a necessary first step toward standardizing the diagnosis and treatment of flatfoot in children.

BACKGROUND: According to literature data, the Oxford Foot Questionnaire for children is a valid instrument for the assessment of complaints and therefore requires adaptation in Russian. AIM: Russian localization of the Oxford Ankle Foot Questionnaire. MATERIALS AND METHODS: Localization of the questionnaire was gradually carried out in accordance with international standards. To specify the accuracy of anatomical comprehension of the lower extremity, 35 children aged 516 years old and their parents were interviewed preliminary. For final validation of the Russian version, the pilot testing was performed in 20 children aged 516 years and their parents. RESULTS: As all the interviewed children correctly anatomically specified the leg, 91.4% of them correctly pointed out the foot, and only 20.0% of children, and 57.0% of the parents were able to find the ankle joint, we translated the phrase ankle and foot as стопа. This was represented in the title and text of the questionnaire items. The final questionnaire version survey illustrated that, generally, children and their parents answered all questions without any difficulties, and additions and clarifications were not essential. CONCLUSIONS: This Russian version of the Oxford Ankle Foot Questionnaire is the only instrument used for the assessment of different foot complaints in children aged 516 years and parents opinion on how much the existing pathology affects the physical, social, and emotional components of childrens complaints.