Flat feet management

Question 1

define flat feet and name two classification

Answer 1

Defined as lower longitudinal medial arch in conjucntion with rear foot eversion
Flexible and Rigid

Question 2

Define Rigid Flat foot and flexible flat foot based on WHO?

Answer 2

• A congenital, rigid or spastic deformity of the foot
  -Flexible Pes planovalgus as a acquired joint

Question 3

Rigid Flat foot aetiology

Answer 3

• congenital vertical talus
  -Tarsal coalition
  Peroneal spastic flat foot
  -Skew foot
  -Fores acting upon abnormally medially deviated TJ
  -Failure of Windlass mechanism of the foot
  -Genetics
  -Tissue stress inc beyond the individual load deformation

Question 4

Flat foot diagnosed via ——-

Answer 4

X-Ray

Question 5

Flat foot Risk factors?

Answer 5

overweight children
Male more likely

Question 6

Is flat feet normal?

Answer 6

• Flexible flat feet are a normal finding in typically developing children which reduces across the first decade of life

Question 7

Characterisitcs of children with flat feet?

Answer 7

-Walk slower.
-Have poorer performance in lower limb involved physical domain.
-Inc hip, knee and back pain

Question 8

What are 3 preferred measurements of flat feet?

Answer 8

-FPI-6
-Stahli arch indices
-Chippaux-smirak indices

Question 9

FPI-6 normative data

Answer 9

Question 10

Flat feet presentation

Answer 10

Question 11

P-FFP leave alone management?

Answer 11

-Leave alone
-Assess
-Good recording
-Good education
-my doors always open

Question 12

P-FFP monitor management?

Answer 12

-Assess
-Educate
Re-assess.
Pending development of Sx
Shoes

Question 13

P-FFP treat management.?

Answer 13

-Wedges, orthosis, Stretches, NSAID’s, Modify comorbid conditions
shoes

Question 14

Foot orthosis prescription recommendation

Question 15

What is the clinical pathway for prescribing foot orthosis in children??

Answer 15

Confirm diagnosis = FPI and RCSP&NCSP
Sign and symptoms
Other sign and symptoms
intervention–> Prefabricated orthosis, , Customised foot orthosis if prefabricated is not effective.
Alternative management

Question 16

In summary when do podiatrists intervene for paeds flat foot?

Answer 16

-Outside of expected measure
-Where there are associated symptoms
Use validated and reliable measure.

Question 17

before prescribing orthotics what do podiatrists need to consider?

Answer 17

-Efficacy
-Expense
-Ethics
-Evidence is not strong for using orthotics foot paeds flat foot j
- first line of Tx is prefab orthotics
- There is very limited evidence for the efficacy of nonsurgical treatment for children with flexible flat foot