Pediatric Flatfoot: Pearls and Pitfalls

Foot Ankle Clin. 2017 Sep;22(3):643-656. doi: 10.1016/j.fcl.2017.04.008. Epub 2017 Jun 3.


Pediatric flatfeet are common, are usually asymptomatic, and typically improve over time as young children age. It is critical to differentiate flexible from rigid flatfeet and to assess for associated Achilles contracture with a careful history, physical examination, and initial radiographs. Although there are limited data, nonsurgical management of symptomatic flatfeet, both flexible and rigid, should be exhausted before considering surgical intervention. If patients fail conservative treatment, surgical management with joint-preserving, deformity-corrective techniques is typically used for pediatric flexible flatfeet in conjunction with deformity-specific soft tissue procedures.

Keywords: Calcaneal lengthening osteotomy; Calcaneal-cuboid-cuneiform osteotomy; Evans procedure; Flatfoot; Hindfoot valgus; Orthoses; Pediatric; Pes planus.

Publication types

  • Review

MeSH terms

  • Arthrodesis / adverse effects
  • Bone Lengthening
  • Calcaneus / surgery
  • Child
  • Flatfoot / diagnostic imaging
  • Flatfoot / therapy*
  • Foot Deformities, Acquired / therapy*
  • Humans
  • Muscle Stretching Exercises
  • Osteotomy / adverse effects
  • Osteotomy / methods*
  • Radiography