Exploring flatfeet morphology in children aged 6-12 years: relationships with body mass and body height through footprints and three-dimensional measurements.

The aim of the study was to determine the relationship between flatfoot morphology and body mass and height in children aged 6-12 years. A total of 6471 Chinese children (mean age 9.0 ± 1.9 years, 41% female) were assessed for foot morphometry, body height, and body mass index. Foot morphology, including foot length, width, girth, arch height, hallux valgus angle, and rearfoot valgus angle, was measured using a 3D laser scanner. Flatfoot evaluations were conducted using the Sztriter-Godunov index (KY) from footprints. All measurements were analyzed by age and sex using the mean values of the left and right sides. Comparisons were performed between flatfoot groups, between body mass index (BMI) groups, and between body height groups. The study revealed a significant decrease in the incidence of bipedal flatfoot with age (p < 0.001), whereas the prevalence of obesity remained consistent (p > 0.05). Bipedal flatfoot was associated with distinct morphological changes, including lower arches, reduced instep height, diminished ankle heights and a greater rearfoot valgus angle (p < 0.05). When comparing the BMI groups, overweight children had larger and thicker feet (p < 0.05), but no differences were found in arch height and ankle height (p > 0.05). When comparing the body height groups, short-statured children had a shorter feet girth, shorter arches, and shorter ankle height (p < 0.05), but no differences were found in the rearfoot valgus angle (p > 0.05). CONCLUSION: The main characteristics of flat feet include lower arches and instep heights and ankle heights but higher rearfoot valgus angles. In general, overweight children's feet do not have the common features of flat feet. In contrast, short children had similar features of flatfoot except for rearfoot valgus. Assessment of posture, such as rearfoot valgus, can be critical in identifying children with flat feet. WHAT IS KNOWN: • The morphology of children's feet is associated with body growth, but the relationship between flatfeet and body mass and height remains controversial. WHAT IS NEW: • Three-dimensional foot measurement shows that body mass is generally not associated with flatfeet, while short children have lower arches but no rearfoot valgus.

Planovalgus Foot Deformity in Patients Undergoing Total Hip Arthroplasty Is Associated With Increased Risk of Falls, Implant-Related Complications, and Revisions: A Case-Control Analysis.

BACKGROUND: Pes planus occurs due to the loss of the longitudinal arch of the foot, resulting in altered gait mechanics. This may lead to increased complications following total hip arthroplasty (THA). Thus, the aim of this study was to assess the effects that pes planus has on rates of falls, implant complications, fall-related injuries, and times to revision among THA patients. METHODS: A retrospective review of a private insurance claims database was conducted from 2010 to 2021. Patients who had a diagnosis of congenital or acquired pes planus and cases of THA were identified. Patients undergoing THA with a diagnosis of pes planus were matched to control patients 1:5 based on age, sex, and comorbidity profiles. Logistic regression was utilized to assess for differences in complication rates. RESULTS: A total of 3,622 pes planus patients were matched to 18,094 control patients. The pes planus group had significantly higher rates of falls than the control group (6.93 versus 2.97%, OR [odds ratio]: 2.43; CI [confidence interval]: 2.09 to 2.84; P < .001). Pes planus patients also had significantly greater odds of dislocation (OR: 1.89; CI: 1.58 to 2.27; P < .001), mechanical loosening (OR: 2.43; CI: 2.09 to 2.84; P = .019), and periprosthetic fracture (OR: 2.43; CI: 2.09 to 2.84; P < .001). The pes planus group had significantly greater rates of proximal humerus fractures (P = .008), but no difference was seen in distal radius fractures (P = .102). The time to revision was significantly shorter in the pes planus group (190 versus 554 days, P < .001). CONCLUSIONS: Pes planus in patients undergoing THA is associated with increased risk of complications and faster time to revision. These findings may allow orthopaedic surgeons to identify those patients at risk and allow for more educated patient counseling and operative planning.

Magnitude of flat foot and its associated factors among school-aged children in Southern Ethiopia: an institution-based cross-sectional study.

BACKGROUND: Flat foot, also known as pes planus, is a common condition among primary school children and is a leading cause of all clinical visits related to foot problems worldwide. It can cause skeletal problems and joint misalignment. This study aimed to assess the magnitude of flat foot and its associated factors among public primary school children. METHODS: An institutional-based cross-sectional study was conducted on 1072 school children aged 11 to 18 years. A structured questionnaire was used for data collection and the footprints were used to calculate the plantar arch index. Data were entered into Epi data version 4.6, and analyzed by STATA version 15. Bivariable and multivariable binary logistic regressions were conducted. Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were calculated. Statistical significance was declared at a P-value < 0.05. RESULT: Out of 1022 participants, 105(10.27%) 95%CI: 8.5-12) had a flat foot. Being male (AOR = 2; 95%CI:1.22-3.30), living in highland altitude (AOR = 8.83; 95% CI: 4.64-16.79), living in midland altitude (AOR = 3.32;95% CI:1.75-6.29), living in an urban area (AOR = 2.42;95% CI:1.15-5.09), insufficient physical activity (AOR = 8.78;95% CI: 4.42-12.3), wearing closed-toe shoes (AOR = 2.33;95%CI:1.27-4.28), obesity (AOR = 6.30;95% CI:3.31-11.9), and foot pain (AOR = 3.52;95%CI:2.08-6.27) had a higher likelihood of flat foot as compared to their counterparts. CONCLUSION: One in every ten children had a flat foot. Altitude, residence, sex, physical activity, foot pain, body mass index, and type of footwear were found to be factors statistically associated with flat foot. Integrated interventions for children to have sufficient physical activity, wearing sandals, maintaining a healthy body mass index, and flatfoot screening and monitoring are recommended.

Characteristics of paediatric foot arches according to body mass among primary school students in Wroclaw, Poland.

BACKGROUND: The purpose of this study, conducted within the framework of the project entitled 'Let's get the kids moving', was to determine the associations between children's longitudinal and transverse foot arch and their weight, gender and age. METHOD: The pro-health initiative 'Let's get the kids moving' was created by researchers of the Medical University and the Run for Health Foundation. A total of 655 children (51.5% boys) aged 7 to 10 years from primary schools in south-western Poland participated in the study. The mean age of the subjects was 8.7 ± 0.8 years. In all the children, we assessed anthropometric measurements (weight and height) and the longitudinal and transverse arch of the foot under the load of their weight. A two-dimensional foot scanner (Sensor Medica, Italy) was used to examine the plantar part of the children's feet. RESULTS: The data collected from the 655 subjects revealed that excessive weight predisposed them to less longitudinal and transverse arching. The foot shape was not differentiated by gender or age. CONCLUSIONS: Screening school-aged children's footprints can detect abnormalities in the shape of children's feet early on, which allows for early diagnosis of functional or structural flatfoot in children.

Osteochondritis dissecans of the talar dome in patients with tarsal coalition.

OBJECTIVE: Tarsal coalition is known to cause abnormal talocrural stress, hindfoot malalignment, and ankle sprains. These can all be associated with osteochondritis dissecans (OCD) of the talar dome. We present the first detailed description of a series of talar OCDs occurring in patients with tarsal coalition, with the goal of determining whether there is an increased prevalence of OCDs among patients with tarsal coalition. MATERIALS AND METHODS: We studied ankle MRIs in 57 patients with tarsal coalitions, excluding those with a reported inciting traumatic event. The MRIs were performed on magnetic field strengths ranging from 0.3 to 1.5 T and included axial, coronal, and sagittal T1 and T2 or PD fat-suppressed sequences. We evaluated the morphology and location of classically described OCDs in these patients, type and location of concomitant tarsal coalition, and, when available, the presence of pes planus and hindfoot valgus on weight-bearing radiographs. Chi-squared analysis was used to compare categorical variables and a Student's t test was used for parametric continuous variables. Additionally, logistic regression was used to compute the odds ratio of talar OCD associated with patient age, gender, laterality, pes planus status, hindfoot valgus status, and coalition type. RESULTS: Eighty-nine percent of tarsal coalitions were non-osseous coalitions and the calcaneonavicular space was the most common site of abnormal tarsal connection (54.4%). In the 29 patients with tarsal coalitions and talar OCDs, OCDs commonly occurred medially (75.9%). In the sagittal plane, talar OCDs occurred centrally, with only one case sparing the central talar dome. The mean surface area of the 29 OCDs was 89.7 mm2. Both osseous coalition and hindfoot valgus were associated with smaller talar OCD mean surface area (p = 0.015 and p = 0.0001, respectively). There was no association between depth and surface area of talar OCD with either coalition location or presence of pes planus (coalition location: p = 0.455 for depth and p = 0.295 for surface area; presence of pes planus: p = 0.593 for depth and p = 0.367 for surface area). CONCLUSION: Talar OCD prevalence is higher in patients with tarsal coalition than that reported for the general population. This occurrence may relate to altered biomechanics and repetitive talocrural stress owing to altered subtalar motion, particularly given the findings of increased odds of talar OCD in older patients, as well as weak associations between OCD surface area and both non-osseous coalition and hindfoot alignment. However, we did not find any specific OCD morphologic features attributable to the precise location of the tarsal coalition.

Paediatric flat foot and foot dimension in Central Anatolia.

BACKGROUND: Information on the foot structures of Central Anatolian children is limited. Foot structures of children aged 6-10 years were shown to be different according to sex and increasing age. OBJECTIVE: This study aimed to compare the foot anthropometric values by age and sex and collect the foot anthropometric data to reveal the relationship between pes planus and pes cavus in the arches of children according to age. METHODS: Footprints of 335 children (180 boys and 155 girls) aged 6-10 years were taken by the pedigraph method and evaluated using 18 different parameters. The TFL (Truncated foot length), FL (foot length), Arch Index, Chippaux Smirak Index, Staheli Arc Index, and foot rotation values of the children were examined. To examine the relationship between the parameters, normality values were examined. Independent samples t-test was used to analyze sex differences in terms of foot size and shape. RESULTS: Correlations between other parameters were determined using the correlations analysis method. TFL, metatarsal circumference, and FL were strongly correlated with age in the children. Foot rotation increased with body mass index in the girls compared to that in the boys. According to the evaluation results with the classification made with the Staheli arch index, 63.3% pes planus, 9.8% pes cavus and 27.7% of the normal arch structure were identified. CONCLUSIONS: Planning shoe production accordingly will contribute to the development of healthy feet in children. This article focused on foot structures of in Central Anatolia and to identify early foot deformities in children. This study found that the length of the TFL was smaller in boys than in girls.

Association between subtalar articular surface typing and flat foot deformity: which type is more likely to cause flat foot deformity.

BACKGROUND: Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity. METHODS: We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane's angle and Bohler's angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot. RESULTS: We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type I and Type IV are significantly severer than Type II (P < 0.05). Type II (7.65 ± 1.38 cm2) was significantly smaller than Type I (8.40 ± 1.79 cm2) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm2) was smaller than Type I (8.40 ± 1.79 cm2), II (7.65 ± 1.38 cm2) and IV (7.81 ± 1.74 cm2) (P < 0.05). Type II (28.81 ± 7.44∘) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler's angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane's angle (P < 0.05). CONCLUSIONS: After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PREVALENCE OF FOOT DEFORMITIES IN YOUNG SCHOOLCHILDREN IN SLAVONIA.

The aim of this study was to determine the occurrence of foot deformity in urban children, as well as possible generational and gender differences using graphic and angular methods. The sample of study subjects included 426 1st to 4th grade schoolchildren (7 to 10 years of age). Out of the total number of schoolchildren, 181 children (88 boys and 93 girls) were measured in 2005, and 244 children (122 boys and 123 girls) in 2011. The results indicated that the largest number of children had no noticeable foot deformity, flat foot in particular. Likewise, there were no gender differences in the occurrence of flat foot and no statistically significant differences in the incidence between the children measured in 2005 and 2011. Due to the problems that foot deformities could cause, it is necessary to continue monitoring foot arches of young schoolchildren in order to intervene on time and prevent the occurrence of deformities by appropriate therapeutic procedures.

Flexible flatfoot of 6-13-year-old children: A cross-sectional study.

BACKGROUND: This cross-sectional study aims to investigate the flexible flatfoot (FFF) prevalence and related factors in school-aged children. METHODS: A total of 1059 children aged 6-13 years were included. Dynamic footprints according to the FootScan system were collected from both feet. The relationship of FFF with age, gender, side, and body mass index (BMI) was investigated. RESULTS: FFF percentage decreased from 39.5% at 6 years to 11.8% at 12 years and reached a plateau at 12-13 years. Overweight (OR 1.35, 95%CI 1.03-1.77, P = 0.03) and obese (OR 2.43, 95%CI 1.81-3.26, P＜0.01) showed a positive correlation with percentage of FFF children. No correlation was found between FFF prevalence and gender or side. CONCLUSIONS: FFF prevalence decreases with age and reaches a plateau at 12-13 years. Moreover, FFF prevalence is positively correlated with increased BMI and body height.

High Rates of Psychiatric Disorders and Below Normal Mental Capacity Associated With Spastic Peroneal Flatfoot: A New Relationship.

Spastic peroneal flatfoot (SPFF) is a rare hindfoot pathology usually seen in the adolescent age group that is characterized by painful spasms in the peroneal muscles. We have clinically observed that patients with SPFF also have some behavioral and emotional difficulties and problems in their academic achievements. Because of these observations, we investigated the prevalence and patterns of psychiatric disorders and intellectual disability among young subjects with SPFF. Our cohort consisted of 16 patients with SPFF. Their mean age at presentation was 21 (range 13 to 31) years. Only 6 patients had a tarsal coalition as an underlying condition. The psychometric evaluation was conducted using validated instruments (Wechsler Intelligence Scale for Children-revised form, Stanford Binet intelligence quotient [IQ] test, and Cattell IQ test). Psychiatric disorders were assessed using a semistructured diagnostic instrument (Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version). The testers and psychiatrists were unaware of the orthopedic condition and the preliminary psychiatric diagnoses. The ethical committee approved the study protocol. The mean follow-up period was 41 (range 12 to 97) months. The mean IQ score of the patients was 75.1 ± 17.9 (range 52 to 107). Compared with the general population, the rate of intellectual disability was significantly greater (p = .0001) and the rate of normal intelligence significantly lower (p = .0015) in our patient group. Furthermore, according to the community schooling ratio, our cohort also had lower junior high and secondary education rates compared with the general population. The rate of most psychiatric disorders diagnosed in the SPFF patients was greater than that in the normal population. The most commonly identified psychiatric disorders were social phobia and attention deficit and hyperactivity disorder (75%). Timely interventions of the psychosocial and academic problems of patients with SPFF might increase their compliance with orthopedic treatment and help with their psychological well-being and academic achievement. In addition, this relationship might be a clue for uncovering the etiology of this disease, which has not yet been clarified.

Lateral collapse of the tarsal navicular in patients with rheumatoid arthritis: Implications for pes planovarus deformity.

OBJECTIVES: In patients with rheumatoid arthritis (RA), the talonavicular joint is commonly involved and midfoot collapse can lead to progressive flattening of the arch. Despite a general awareness of the important structural role of the talonavicular joint in rheumatoid foot disease, details of its destructive pattern have not been elucidated. METHODS: We cross-sectionally investigated 176 RA patients (342 feet) and classified their feet into the following five groups according to radiographic findings: arthritis (RA changes with normal navicular shape), Müller-Weiss Disease (MWD) (collapse of the lateral aspect of the tarsal navicular), flat (flattened navicular), ankylosis (ankylosis of the talonavicular joint), and normal. We compared medical histories and radiographic measurements among all five groups. RESULTS: The arthritis group comprised 91 feet, 36 in the MWD group, nine in the flat group, 12 in the ankylosis group, and 194 classified as normal. The MWD group demonstrated a trend towards pes planovarus deformity in contrast to pes planovalgus deformity in the arthritis group. Corticosteroid use and the mean daily dosage were the highest in the MWD group. CONCLUSIONS: This report revealed a high prevalence of MWD-like changes to the navicular in RA patients and its association with pes planovarus deformity and corticosteroid usage.

Utility outcome assessment of pes planus deformity.

BACKGROUND: Despite being a common condition, there are no objective measures in the literature to reflect the burden of pes planus on affected individuals. Our primary objective was to evaluate this burden by recruiting a sample from the general population using validated utility outcome measures. METHODS: Participants were recruited online and filled a questionnaire to help measure the health burden of pes planus. Three recognized utility outcome scores were used to compare the health burden of monocular blindness, binocular blindness, and pes planus. These included the standard gamble (SG), time trade-off (TTO), and visual analogue score (VAS). Paired t test, independent t test, and linear regression were used for statistical analysis. RESULTS: Ninety-two participants were included in the final analysis. The utility outcome scores (VAS, TTO, SG) for pes planus were 73±17, 0.90±0.08, and 0.88±0.12, respectively. The linear regression analysis showed that age was inversely proportional to the time trade-off. However, race, educational level, and income were not significant predictors of utility outcome score for pes planus. CONCLUSIONS: This study shows that the perceived burden of living with pes planus is comparable to living with some debilitating conditions. Our participants were willing to sacrifice 3.6 years of life, and have a procedure with a theoretical 12% mortality risk to attain perfect health.

Correlation between Foot Arch Index and the Intensity of Foot, Knee, and Lower Back Pain among Pregnant Women in a South-Eastern Nigerian Community.

OBJECTIVES: The aim of this study was to assess the arch height index of pregnant women and its correlation with foot pain, anterior knee pain, and lower back pain. SUBJECTS AND METHODS: Two hundred and fifteen consenting pregnant women participated in this cross-sectional study. The arch height index was assessed from their foot prints, while pain intensity was rated on a numerical rating scale. Data were summarized with descriptive statistics and the Pearson correlation was used to determine correlations between the variables at p < 0.05. RESULTS: Of the 215 pregnant women, 123 (57.2%) and 127 (59.9%) had low arch heights on the right and left feet, respectively, and the mean arch height indices were 0.27 ± 0.71 for the right foot and 0.28 ± 0.07 for the left foot. The prevalence of foot, knee, and lower back pain was 65 (30.2%), 43 (20.0%), and 93 (43.3%), respectively. The Pearson correlation analysis did not reveal any significant relationship (p > 0.05) between foot pain and each of the right (r = -0.010, p = 0.886) and left (r = 0.004, p = 0.955) arch indices as well as between knee pain and each of the right (r = 0.042, p = 0.536) and left (r = 0.045, p = 0.515) arch indices. A similar trend was observed for the lower back, which also did not show any significant relationship to each of the right (r = 0.026, p = 0.703) and left (r = 0.097, p = 0.157) arch indices. CONCLUSION: The study participants had a high prevalence of low foot arches, indicating pes planus. Lower back pain was more common than foot and knee pain. The foot arch heights did not show any relationships between the intensities of foot, anterior knee, and lower back pain.

Investigation of the Relationship Between Flatfoot and Patellar Subluxation in Adolescents.

Patellar subluxation is common in adolescents, and a variety of factors are related to this condition, with valgus of the knee joint an important factor. The results of many studies suggest that flatfoot can cause an abnormality of the lower limb power line. Structural abnormalities of the foot caused by the high stresses exerted by body weight can lead to structural deformity of the knee and can also cause knee valgus. Screening for foot problems can help determine the risk of patellar subluxation, and early intervention can lessen the incidence of this condition. The purpose of the present study was to investigate the effects of flatfoot on the structure and function of the knees and, especially, the risk of patellar subluxation. A total of 72 participants were recruited for this cross-sectional study. The mean age at examination was 15.4 ± 4.0 (range 9 to 22) years. The measured parameters were heel valgus angle, arch index, and quadriceps angle (Q-angle). Overall, the mean values of the heel valgus angle, arch index, and Q-angle were 5.9° ± 2.4° (range 1° to 11°), 0.33 ± 0.07 (range 0.23 to 0.46), and 19.1° ± 3.5° (range 9° to 26°), respectively. The Q-angle was directly associated with the heel valgus angle (r = 0.818, p < .001) and arch index (r = 0.655, p < .001). We found that flatfoot can affect the morphology of the knee joint and increase the risk of patellar subluxation.

Genu Valgum and Flat Feet in Children With Healthy and Excessive Body Weight.

PURPOSE: To examine the relationship between obesity, genu valgum, and flat feet in children, and find practical implications for therapeutic interventions. METHODS: A total of 1364 children aged 3-7 years took part in the research. Their body mass index was calculated and their weight status described. Participants' knee alignment was assessed by measuring the intermalleolar distance in the standing position with the knees in contact. The height of the longitudinal arch of each foot was measured using Clarke's angle. RESULTS: The prevalence of overweight and obesity increased with age. Reduction of intermalleolar distance and increased longitudinal arch of the foot, characteristic of typical growth and development, were observed. Genu valgum was more common in children who were overweight. Significant correlations among body mass index, intermalleolar distance, and Clarke's angle (P < .05) were also discovered. CONCLUSION: Children who are overweight or demonstrate obesity are more likely to develop genu valgum and flat feet.

Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older.

BACKGROUND: Research is needed to determine the prevalence and variables associated with the diagnosis of flatfoot, and to evaluate the validity of three footprint analysis methods for diagnosing flatfoot, using clinical diagnosis as a benchmark. METHODS: We conducted a cross-sectional study of a population-based random sample ≥ 40 years old (n = 1002) in A Coruña, Spain. Anthropometric variables, Charlson's comorbidity score, and podiatric examination (including measurement of Clarke's angle, the Chippaux-Smirak index, and the Staheli index) were used for comparison with a clinical diagnosis method using a podoscope. Multivariate regression was performed. Informed patient consent and ethical review approval were obtained. RESULTS: Prevalence of flatfoot in the left and right footprint, measured using the podoscope, was 19.0% and 18.9%, respectively. Variables independently associated with flatfoot diagnosis were age (OR 1.07), female gender (OR 3.55) and BMI (OR 1.39). The area under the receiver operating characteristic curve (AUC) showed that Clarke's angle is highly accurate in predicting flatfoot (AUC 0.94), followed by the Chippaux-Smirak (AUC 0.83) and Staheli (AUC 0.80) indices. Sensitivity values were 89.8% for Clarke's angle, 94.2% for the Chippaux-Smirak index, and 81.8% for the Staheli index, with respective positive likelihood ratios or 9.7, 2.1, and 2.0. CONCLUSIONS: Age, gender, and BMI were associated with a flatfoot diagnosis. The indices studied are suitable for diagnosing flatfoot in adults, especially Clarke's angle, which is highly accurate for flatfoot diagnosis in this population.

The nutritional status and the height of the arch of the foot in preschool children.

AIM: Childhood obesity is an increasingly common problem. It is associated with poor posture especially with lower limb deformities. The study aimed at assessing the prevalence of overweight and obesity in preschoolers, the analysis also contained the relationship between the nutritional status and the foot arching. METHODS: One thousand two hundred ninety-four children at the age from 3 to 6 years took part in the study. The height and weight of the children were measured. From these measurements, the BMI and Cole Index values were calculated. The prevalence of overweight and obesity were estimated. The degree of foot arching was measured using a podoscope and categorised according to Clarke's angle (CA). Differences in CA between right and left foot were analysed across all groups according to age and gender. Secondly CA for both feet was compared between girls and boys from all age groups. Thirdly, CA was compared for the same gender but between different age groups. Finally, nutritional status and CA for the right and left foot were correlated. Basic descriptive statistics, the U Mann-Whitney test, a one-way ANOVA and the linear correlation study were used to verify the presence of trend. RESULTS: Twenty percent of boys and 15.7% of girls were found overweight, and 9.8% of both male and female subjects were found obese. The prevalence of overweight increased with age. The longitudinal arch of the foot was higher in girls. It increased with age. The height of the longitudinal arch of the foot was smaller in overweight and obese children. CONCLUSION: A substantial number of overweight and obese preschoolers took part in the study, in which a significant dependence between excessive body weight and flat feet was found. The preschool education programmes should include pro-health exercises combining aerobic training with exercises developing good body posture habits.

The Prevalence of Spine Deformities and Flat Feet among 10-12 Year Old Children Who Train Basketball--Cross-Sectional Study.

The aim of this study is to estimate the prevalence of spine and feet deformities among children who are regularly involved in basketball trainings, as well as finding differences in the prevalence of those deformities between children of different gender and age. The study included a total of 64 children, of which 43 were boys and 21 were girls, ages 10-12. All subjects have been regularly participating in basketball trainings for at least one year. Postural disorder is defined as an irregularity in posture of the spine and feet, and it is assessed by visual methods from the front, side and rear side of the body. The prevalence of spinal deformities in our group was 53.13%. The boys had a significantly higher prevalence than girls, 65.1% compared to 28.57% (p=0.006). There was no significant difference in prevalence of spine deformities between children of different ages. The prevalence of feet deformities was 64.06%. There was a statistically significant difference between the sexes, where boys had a significantly greater prevalence of the feet deformities than girls, 83.7% compared to 23.81% (p=0.001). Flat feet were the most common in 10 year old children (85.71%). In conclusion, it can be said that despite regular participation in basketball training, subjects in this study have high prevalence of deformities; especially boys who stand out with the high prevalence of flat feet.

Pediatric flatfoot: cause, epidemiology, assessment, and treatment.

PURPOSE OF REVIEW: The current review includes the most up to date literature on the cause, epidemiology, diagnosis, and treatment of pediatric flatfeet. RECENT FINDINGS: Recent systematic reviews concur that the evidence supporting the use of orthotics in pediatric flexible flatfeet is poor. Multiple studies have recently reported on the results of arthroereisis, yet these are mostly retrospective and do not include a comparative group or long-term follow up. Other options for symptomatic flatfeet may include osteotomies and/or fusions, but similarly high quality comparative studies are lacking. SUMMARY: Pediatric flatfeet range from the painless flexible normal variant of growth, to stiff or painful manifestations of tarsal coalition, collagen abnormalities, neurologic disease, or other underlying condition. Most children with flexible flatfeet do not have symptoms and do not require treatment. In symptomatic children, orthotics, osteotomies, or fusions may be considered. Arthroereisis has gained popularity in Europe, but has not been widely adopted in North America. Children with asymptomatic rigid flatfeet may not require treatment, whereas those with pain or functional deficits may benefit from orthotics, osteotomies, or fusions. A careful history, clinical exam, and selective diagnostic testing can be used to determine the appropriate treatment option for each child.

Serial casting for neuromuscular flatfoot and vertical talus in an adolescent with hereditary spastic paraplegia.

PURPOSE: The purpose of this report is to explore assessment and serial casting intervention for painful rigid flatfoot deformities with vertical talus in an adolescent girl with hereditary spastic paraplegia who was nonambulatory. SUMMARY OF KEY POINTS: The participant's right foot underwent 2 phases of casting with correction first toward hindfoot inversion and then dorsiflexion. Because of a vertical talus, her left foot required an intermediate casting toward plantar flexion, inversion, and forefoot adduction prior to casting toward dorsiflexion. STATEMENT OF CONCLUSIONS: The patient improved despite the underlying progressive neuromuscular disorder. Pain ameliorated and she returned to supported standing and transfers. Spasticity decreased bilaterally and the flexibility of her foot deformities improved to allow orthotic fabrication in subtalar neutral. Results were maintained at 12 and 16 months. RECOMMENDATIONS FOR CLINICAL PRACTICE: Individualized multiphase serial casting requires further investigation with patients such as those with hereditary spastic paraplegia.