How should you treat a child with flat feet?

Abstract

Flexible flatfoot (FFF)doesn�۪t increase the risk of injury or pain during exercise (strength of recommendation [SOR]: B, 2 small prospective cohort studies). Treating FFF with orthotics doesn�۪t change the course of arch development (SOR: B, 2 small randomized controlled trials [RCTs]). FFF is usually asymptomatic, but symptomatic FFF may respond to activity modification, orthoses, and stretching (SOR: C, expert opinion). Rigid flatfoot results from trauma, neuromuscular disorders, or congenital bone malformations (SOR: C, expert opinion). Treatment may require surgery, including osteotomy and arthrodesis, depending on the underlying pathology (SOR: C, expert opinion). No long-term outcome studies of surgical treatment have been performed.