The attitude of doctors of various specialties to the problem of flatfoot

Abstract

Purpose: to assess the subjective perception of flatfoots prevalence in children, its age dynamics and the main approaches to the diagnosis and treatment by doctors of various pediatric specialties with different medical experience and working in medical facilities at various levels by anonymous questionnaire.
 Materials and methods. Questionnaire data from 80 orthopedists (50 outpatient doctors, 30 doctors from a specialized scientific research institute and orthopedic departments of city hospitals (research institutes / hospitals) and 30 neurologists (polyclinic).
 Results: our study demonstrated that outpatient orthopedists diagnose the flatfoot on average in half of the cases. The orthopedists diagnose flatfoot only by means of visual examination in 46.1% of cases (neurologists in 85.7% of cases). According to our data, 58.9 % of outpatient doctors recommend wearing special orthopedic shoes (46.1 % only if the foot alone is affected) and 95.1 % of specialists recommend wearing individual orthopedic insoles (53.6 % if there are complaints). While 88.2 % of the orthopedic surgeons from specialized research institutes and hospitals do not recommend wearing orthopedic shoes; 26.7 % of experts recommend wearing individual orthopedic insoles only in the presence of complaints. On the other hand, the neurologists recommend wearing orthopedic shoes 5.3 times more often than the orthopedists do.
 Conclusion: our study demonstrates that the specialty of the doctor (orthopedist, neurologist) and the type of health care facilities in which the specialist works have the greatest impact on his subjective perception of the prevalence and age dynamics of flatfoot in children, tactics of diagnostics and treatment. The outpatient orthopedists diagnose flatfoot 4.2 times more often than the orthopedic surgeons from the specialized research institute and hospitals. Also, the outpatient orthopedists prescribe wearing orthopedic shoes 4.9 times more often (insoles 3.6 times more often) in comparison with the orthopedic surgeons of the specialized research institute and orthopedic hospitals. Summarizing the above mentioned, we would like to note that due to the fact that the current assessment of the age limits of the arch height feet is ambiguous, there is a need to introduce a unified system for assessing the foots shape and posture with defining the concepts of average height and typically developing foot.