Pediatric flatfoot - treatment options
They say things come in 3's and this week it was pediatric flatfeet. I usually don't see that many children in my office but this week was an exception.
What can be done for children with flatfeet? The literature isn't very clear when it comes to the treatment of pediatric flatfeet. In my practice, I do very little flatfoot surgery. By far, the most common pediatric flatfoot case is one in which there is a symptomatic os trigonum. The os trigonum is an accessory bone that forms within the body of the posterior tibial tendon, at the medial aspect of the navicular bone. and in each of these cases, the children are limited by pain from participating in sports or other activities in which they need to be on their feet for extended periods of time.
Pediatric flatfoot - arch cookies
Conservative care for pediatric flatfeet includes the use of arch cookies or arch supports. I tend to lean to arch cookies for early walkers (age 2-4 y/o) and use arch supports in older children. If I need more correction and want to err to the side of more support, I'll typically use a UCBL. The UCBL orthotic has a firm polypropylene arch and lateral flange. The lateral flange will block the lateral heel, inhibiting pronation.
Pediatric flatfoot - Birkobalance pediatric arch supports
But this week we had a run on 5-8 y/o children with mildly symptomatic flatfeet. In this case I fall back on the use of the BirkoBalance Pediatric support. The BirkoBalance is semi-firm and much better tolerated by children. And I think they like the colors too. Anything you can do to get the kids to wear these, right?
Jeffrey A. Oster, DPM