Diagnosis and treatment of pediatric flatfoot

Foot and ankle specialists acknowledge that flatfoot deformity is a frequently encountered pathology in the pediatric population. Flattening of the medial arch is a universal finding in flatfoot and it is common in both pediatric and adult populations. Pediatric flatfoot comprises a group of conditions occurring in infants, children, and adolescents (1) that are distinguished by anatomy and etiologic factors (2, 3–8). Flatfoot may exist as an isolated pathology or as part of a larger clinical entity (4). These entities include generalized ligamentous laxity, neurologic and muscular abnormalities, genetic conditions and syndromes, and collagen disorders. Pediatric flatfoot can be divided into flexible and rigid categories. Flexible flatfoot is characterized by a normal arch during nonweightbearing and a flattening of the arch on stance (Fig 1). Flexible flatfoot may be asymptomatic or