Flat feet (ภาวะ เท้า แบน which is the term in Thai) are a common and normal disorder in babies and young children. They occur because the tissues in the foot that hold the joints together are still soft. The recommended treatments are generally wearing orthopedic insoles, rehabilitation, or even surgery if the flat feet are very debilitating.
Flat Feet: Definition
Hypotonic flatfoot is linked to muscle and ligament deficiency in a child who is often large and hypotonic. The internal longitudinal arch collapses and causes changes in the overall architecture of the foot. The heel turns outward, in valgus. Deprived of its calcaneal support and placed cantilevered under the body’s weight, the head of the talus swivels and lowers, pulling the entire internal arch towards the ground. The forefoot tilts out. In the beginning, the foot remains flexible, and the deformations are reducible.
Painful muscle contractures may appear around 12 or 13 years of age, and the deformities become irreducible around 16 or 18 years old.
In some cases, the flat foot is not due to hypotonia but to an Achilles tendon too short. The rearfoot goes out, and the arch of the foot crashes. This variety of flatfoot is a spontaneous correction of the equine due to the retraction of the Achilles tendon. What is the cause of Achilles tendon retraction? It can be idiopathic (without recognized cause) or testify to a very discreet neonatal neurological attack (mini- Cerebral Palsy).
It is a trivial and common condition that progresses without any treatment thanks to the growth in 90% to 97% of cases. In 3 to 10% of cases, the flat foot becomes embarrassing and sometimes requires surgical treatment between 4 and 8 years.
We must look for the existence of a genu valgum by measuring the inter-malleolar distance. The flat foot can be consecutive or the triggering factor of the genu valgum. The hips and spine are then examined.