Prevalence of flat foot in preschool-aged children

Pediatrics. 2006 Aug;118(2):634-9. doi: 10.1542/peds.2005-2126.


Objectives: Our aim with this study was to establish the prevalence of flat foot in a population of 3- to 6-year-old children to evaluate cofactors such as age, weight, and gender and to estimate the number of unnecessary treatments performed.

Methods: A total of 835 children (411 girls and 424 boys) were included in this study. The clinical diagnosis of flat foot was based on a valgus position of the heel and a poor formation of the arch. Feet of the children were scanned (while they were in a standing position) by using a laser surface scanner, and rearfoot angle was measured. Rearfoot angle was defined as the angle of the upper Achilles tendon and the distal extension of the rearfoot.

Results: Prevalence of flexible flat foot in the group of 3- to 6-year-old children was 44%. Prevalence of pathological flat foot was < 1%. Ten percent of the children were wearing arch supports. The prevalence of flat foot decreases significantly with age: in the group of 3-year-old children 54% showed a flat foot, whereas in the group of 6-year-old children only 24% had a flat foot. Average rearfoot angle was 5.5 degrees of valgus. Boys had a significant greater tendency for flat foot than girls: the prevalence of flat foot in boys was 52% and 36% in girls. Thirteen percent of the children were overweight or obese. Significant differences in prevalence of flat foot between overweight, obese, and normal-weight children were observed.

Conclusions: This study is the first to use a three-dimensional laser surface scanner to measure the rearfoot valgus in preschool-aged children. The data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. In overweight children and in boys, a highly significant prevalence of flat foot was observed; in addition, a retarded development of the medial arch in the boys was discovered. At the time of the study, > 90% of the treatments were unnecessary.

MeSH terms

  • Age Distribution
  • Anthropometry / instrumentation
  • Austria / epidemiology
  • Body Weight
  • Child
  • Child, Preschool
  • Comorbidity
  • Female
  • Flatfoot / diagnosis
  • Flatfoot / epidemiology*
  • Flatfoot / therapy
  • Humans
  • Lasers
  • Male
  • Obesity / epidemiology
  • Orthotic Devices
  • Overweight
  • Prevalence
  • Shoes