Diagnosis and treatment of pediatric flatfoot

Harris, Edwin J.; Vanore, John V.; Thomas, James L.; Kravitz, Steven R.; Mendelson, Stephen; Mendicino, Robert W.; Silvani, S H; Gassen, Susan Couture

doi:10.1053/j.jfas.2004.09.013

Cited by 181 publications

(171 citation statements)

References 106 publications

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“…These medical conditions differ among themselves by anatomy and aetiological factors [5][6][7][8][9][10][11]. Regarding paediatric flatfoot, it may exist as an isolated pathology or as part of a larger clinical entity [7], such as generalized ligamentous laxity, neurologic and muscular abnormalities, genetic conditions and syndromes, and collagen disorders [12].…”

Section: Introductionmentioning

confidence: 99%

“…Given these considerations, paediatric flatfoot can be divided into two main categories, flexible and rigid. Flexible flatfoot is characterized by a normal arch during nonweightbearing and a flattening of the arch on stance [12]. Conversely, rigid flatfoot is characterized by a stiff, flattened arch on and off weightbearing [12].…”

Section: Introductionmentioning

confidence: 99%

“…Flexible flatfoot is characterized by a normal arch during nonweightbearing and a flattening of the arch on stance [12]. Conversely, rigid flatfoot is characterized by a stiff, flattened arch on and off weightbearing [12]. Due to the absence or presence of symptoms, flexible flatfoot may be asymptomatic or symptomatic.…”

Section: Introductionmentioning

confidence: 99%

“…For the diagnosis of paediatric symptomatic flexible flatfoot, it is important to take into account the following factors: medical history of the paediatric patient, the degree of severity of subjective symptoms, physical findings obtained during the clinical examination, analysis of the obtained footprint, and diagnostic imaging studies, which may include weightbearing radiographs, bone scans, computed tomography (CT), and magnetic resonance imaging (MRI) [12].…”

Section: Introductionmentioning

confidence: 99%

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Navicular index for differentiation of flatfoot from normal foot

Roth

Jotanović

et al. 2013

International Orthopaedics (SICOT)

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Purpose The height of navicular bone from the floor is in proportion with the height of longitudinal arch of the foot. The study was conducted to evaluate correlation of navicular bone height with most often used angles, heel valgus and a foot print in order to simplify the procedure for the diagnosis of flatfoot. Methods A total of 218 operated children (436 feet) because of flexible flatfoot were evaluated clinically and radiologically. Meary angle, lateral talonavicular angle, talocalcaneal angle, calcaneal pitch, heel valgus and arch index (Staheli) were evaluated pre-operatively and postoperatively. In 121 (242 feet) chosen children (age eight to 15) with all clinical values and pre-operative angles corresponding flatfoot, all postoperatively measured values were within the normal range. We got the navicular index by dividing length of longitudinal arch with navicular height. Values of navicular index were then compared with pre-operatively and postoperatively measured values. Pearson correlation and ROC test were used for statistical analysis. Results Values of the navicular index for flatfeet were in the interval from 4.75 to 31.2 (median 8.98), and for normalarched feet 3.58-22.6 (median 5.48). Pearson correlation of arch index and measured parameters were significant in majority, and degree according to Colton was good. Area under the ROC curve was 0.861 (p=0.0001). The cut-off value with 86 % sensitivity and 75 % specificity was 6.7407. Conclusion Navicular index can be used reliably, without measures of the other parameters, to differentiate flatfoot from normal-arched foot. Therefore, the navicular index has an ability to distinguish between the flatfoot and normalarched foot.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Navicular index for differentiation of flatfoot from normal foot

Roth

Jotanović

et al. 2013

International Orthopaedics (SICOT)

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“…Clinicians should distinguish between flexible and rigid pes planus. 117 Rigid pes planus is present when standing (weightbearing) and sitting (non-weight bearing) and is commonly indicative of underlying pathology, Flexible pes planus is present with standing (weight bearing) only, and is more common and usually asymptomatic. Clinicians should investigate age of onset, family history, associated medical conditions, associated symptoms, trauma history, activity level, and any previous treatment.…”

Section: Pes Planusmentioning

confidence: 99%

Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review

et al. 2016

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Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits.

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