Comparative analysis of the foot position in children with symptomatic and asymptomatic flatfoot using the foot posture index (FPI-6)

Abstract

Aim. To compare the foot position in asymptomatic children and those who received conservative or surgical because of flatfoot.

Materials and Methods. We consecutively recruited three patient groups: 112 healthy children, 74 children with a pronation position, and 80 children with an overpronation position of the foot. The Foot Posture Index (FPI – 6) was used for the clinical examination. Visual and manual clinical tests were used to determine the mobility of the foot joints. X-ray was performed in a standard lateral projection with a load; if necessary, multislice computed tomography of the foot was performed.

Results. Healthy children commonly have pronation position of the foot during the first 10 years of life, with the further normalisation of the posture. In patients receiving conservative treatment of foot pronation, normalisation of the foot position was considerably less pronounced than in healthy children. Further, in those with overpronation position, there were no age-dependent changes in the posture and surgery was the only efficient approach to correct the flatfoot.

Conclusion. FPI-6 is a highly sensitive tool for clinical diagnosis of flatfoot. Moderate pronation has a more favorable prognosis than the overpronation position, which is not corrected during the body growth or by the conservative treatment. Yet, surgery is a safe and efficient approach to relieve the pain syndrome and treat the flatfoot deformity.