Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 634-639 (doi:10.1542/peds.2005-2126)
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ARTICLE

Prevalence of Flat Foot in Preschool-Aged Children

Martin Pfeiffer, MDa, Rainer Kotz, Prof MDa, Thomas Ledl, MScb, Gertrude Hauser, Prof MDc and Maria Sluga, Prof MDa

a Department of Orthopedics, Medical University of Vienna, Vienna, Austria
b Institute of Scientific Computing, University of Vienna, Vienna, Austria
c Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria

OBJECTIVES. Our aim with this study was to establish the prevalence of flat foot in a population of 3- to 6-year-old children to evaluate cofactors such as age, weight, and gender and to estimate the number of unnecessary treatments performed.

METHODS. A total of 835 children (411 girls and 424 boys) were included in this study. The clinical diagnosis of flat foot was based on a valgus position of the heel and a poor formation of the arch. Feet of the children were scanned (while they were in a standing position) by using a laser surface scanner, and rearfoot angle was measured. Rearfoot angle was defined as the angle of the upper Achilles tendon and the distal extension of the rearfoot.

RESULTS. Prevalence of flexible flat foot in the group of 3- to 6-year-old children was 44%. Prevalence of pathological flat foot was <1%. Ten percent of the children were wearing arch supports. The prevalence of flat foot decreases significantly with age: in the group of 3-year-old children 54% showed a flat foot, whereas in the group of 6-year-old children only 24% had a flat foot. Average rearfoot angle was 5.5° of valgus. Boys had a significant greater tendency for flat foot than girls: the prevalence of flat foot in boys was 52% and 36% in girls. Thirteen percent of the children were overweight or obese. Significant differences in prevalence of flat foot between overweight, obese, and normal-weight children were observed.

CONCLUSIONS. This study is the first to use a three-dimensional laser surface scanner to measure the rearfoot valgus in preschool-aged children. The data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. In overweight children and in boys, a highly significant prevalence of flat foot was observed; in addition, a retarded development of the medial arch in the boys was discovered. At the time of the study, >90% of the treatments were unnecessary.

Key Words: foot • rearfoot angle • preschool children • flat foot • correlating factors

Accepted Mar 20, 2006.


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