Abstract
Flexible flatfoot is a common condition in small children, which shows a strong tendency to spontaneously correct with their growth or to become moderate or mild in adults, which will not cause future problems. However, in a small number of cases, this condition is more severe, does not improve spontaneously, which may cause mechanical impairment, deformity, and, eventually, pain. In such cases, surgical treatment should be considered. The aim of this systematic review was to evaluate the literature results on the treatment of the symptomatic flexible flatfoot in children or adolescents through a very frequent procedure: calcaneal lateral column lengthening osteotomy, A systematic electronic search in PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS and LILACS databases was performed. We searched articles published between March 1975 and September 2016. After applying the eligibility criteria, the selected publications were evaluated in relation to their clinical and radiographic results and complications. We found 341 articles in the mentioned databases, but selected only eight studies, according to the inclusion and exclusion criteria. These studies included a total of 105 patients and 167 treated feet. Only three authors performed prospective studies, but without case-control or randomization. The majority of publications were descriptive studies or case series (level of evidence III or IV), with great methodological variations, but with a high satisfaction rate on the part of both patients and surgeons in relation to the results. However, more prospective and randomized studies are required, with adequate control groups and validated evaluation criteria.
Highlights
Despite being a frequent affection, the flexible valgus flatfoot does not show objective diagnostic criteria[1]
Flexible flatfoot occurs when there is subtalar joint and foot mobility, so that the deformity can be reversed by maneuvers standing on the tiptoes or at the lateral border of the foot, or not bearing weight[2]
Most children are born with flatfoot, but the medial plantar arch mainly develops between two and six years of age[3]
Summary
Despite being a frequent affection, the flexible valgus flatfoot does not show objective diagnostic criteria[1]. It is characterized by the loss or inversion of the medial longitudinal plantar arch associated with valgus hindfoot and supination of the forefoot. Flexible flatfoot occurs when there is subtalar joint and foot mobility, so that the deformity can be reversed by maneuvers standing on the tiptoes or at the lateral border of the foot, or not bearing weight[2]. Most children are born with flatfoot, but the medial plantar arch mainly develops between two and six years of age[3]. There is no scientific evidence that these measures act to correct the deformity[5], maybe they are only palliative
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