What is Flatfoot?

Flatfoot: What is it and what are it’s Types?

The sole of our foot is usually not flat. Most of us have an elevated arch in the foot called the MEDIAL LONGITUDINAL ARCH (Figure 1). Absence of the arch of the foot is called flatfoot.

Figure 2: Flatfoot

What are types of flatfoot?

Broadly flatfoot are of two types:

(1) Flexible flatfeet: These are feet in which arch is seen when the child is not bearing weight on the limb. However when the child stands and bears weight, the arch collapses and the foot becomes flat.

(2) Rigid flatfoot: These are feet in which arch is not formed and the foot remains flat even when the child is not bearing weight on the limb.

Figure 4: Flexible flatfoot: The arch is seen when the child is not bearing weight on the limb. But the foot becomes flat when the child bears weight on the limb. 

How is flatfoot treated?

(1) FLEXIBLE FLATFOOT IN CHILD < 10 YEARS AGE: Flexible flatfeet in children less than 10 years age are normal don’t need any treatment. The reason for this is that as the child grows older the ligaments supporting the foot arch become stronger and normal arch is usually restored by the age of 10 years.

(2) FLEXIBLE FLATFOOT IN CHILD > 10 YEARS AGE: Treatment of flexible flatfoot in child more than 10 years age depends on (1) Severity of deformity (2) Pain.

If the deformity is not too severe and there is no pain, flexible flatfeet in children more than 10 years age are treated with physiotherapy and soft cushion shoe inserts.

If the deformity is severe or the child experiences pain (most commonly underneath the collapsed arch of foot), flexible flatfeet in children more than 10 years age need surgery.

The surgery most commonly performed for his condition is called the Calcaneal Lengthening Osteotomy which is a surgery aimed at restoring the arch of the foot.

(3) RIGID FLATFOOT: Children with rigid flatfeet have underlying bony deformities (e.g. rocker bottom foot in the newborn, tarsal coalition in adolescent children). These cases need to be evaluated with appropriate X-rays/ MRI/ CT scan. These cases need surgery for correction of deformity.

Conclusion

Flexible flatfeet in young children are normal and don’t need any treatment. However, flatfeet which persist into adolescent age group/ those which are severe/ those which are painful and rigid flatfeet need careful evaluation and treatment, either in the form of physiotherapy/ shoe inserts or surgery.

_ By Dr Sandeep Vaidya, Paedictric Orthopaedic Surgeon, Pinnacle Orthocentre Hospital. For more information, mail drsvvaidya@gmail.com/ call 7028859555.