{"id":8573,"date":"2022-07-27T13:16:10","date_gmt":"2022-07-27T12:16:10","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=8573"},"modified":"2023-09-14T16:36:50","modified_gmt":"2023-09-14T15:36:50","slug":"paediatric-flat-foot","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatric-flat-foot\/","title":{"rendered":"Flat Foot"},"content":{"rendered":"\n<p><strong>Information<\/strong><\/p>\n\n\n\n<p><strong>Paediatric Flexible Flat Foot<\/strong><\/p>\n\n\n\n<p>Flexible flat feet are normal variants caused by increased flexibility of the joints and ligaments of the foot. This is present in 90% of 1 year olds and up to 20% of adults. The arch of the foot usually takes up until 10 years of age to completely develop.<\/p>\n\n\n\n<p>Diagnosis can be aided by observing a difference in arch height from weight bearing to non-weight bearing, heel inversion on tip toe standing and arch formation on hallux dorsiflexion.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>\u200bInitial self management of this condition is encouraged please see resources below. If self management fails please follow the criteria below<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p><strong>Consider referring children with flat feet for specialist assessment, using clinical judgement to determine the urgency, if&nbsp;<\/strong><strong><em>any<\/em><\/strong><strong>&nbsp;of the following are present:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Flexible and painful flat feet, or previously painless flat feet that become symptomatic.<\/li>\n\n\n\n<li>Absent medial longitudinal arch when the child is on tiptoes or when big toes are extended.<\/li>\n\n\n\n<li>Rigid flat feet (especially in adolescents \u2014 possible tarsal coalition).<\/li>\n\n\n\n<li>Asymmetrical flat feet.<\/li>\n\n\n\n<li>Tripping or frequent falls.<\/li>\n\n\n\n<li>Limp.<\/li>\n\n\n\n<li>Functional limitation.<\/li>\n\n\n\n<li>Fatigue of the foot muscles, signs of pressure such as calluses or blistering to the foot, or recurrent ankle sprains.<\/li>\n\n\n\n<li>Marked hypermobility.<\/li>\n\n\n\n<li>Morning stiffness, restriction of joint movement, joint swelling (of any joint, not just the foot\/ankle), or abnormal joint examination.<\/li>\n\n\n\n<li>Regression or delayed motor milestones.<\/li>\n\n\n\n<li>Other features indicative of an underlying diagnosis, for example neurological (cerebral palsy), muscular (muscular dystrophy), syndromic (trisomy 21) or connective tissue (Marfan&#8217;s and Ehlers-Danlos syndromes).<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p>Asymptomatic flat feet<br><br>Patients who are undergoing management for this condition with another service.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>\u200bGeneral advice<\/p>\n\n\n\n<p>Footwear advice leaflet<\/p>\n\n\n\n<p>Activity modification to manage symptoms.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>For Patients<\/strong><\/p>\n\n\n\n<p>NHS Lothian Podiatry Patient Information Leaflet:&nbsp; &nbsp;<a href=\"https:\/\/policyonline.nhslothian.scot\/Policies\/PatientInformation\/Childrens_Footwear.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Children&#8217;s Footwear (nhslothian.scot)<\/a><\/p>\n\n\n\n<p>Royal College of Podiatry Flatfoot Patient Information&nbsp;&nbsp;<a href=\"https:\/\/rcpod.org.uk\/common-foot-problems\/flat-foot-management\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/rcpod.org.uk\/common-foot-problems\/flat-foot-management<\/a><\/p>\n\n\n\n<p><strong>For Health Professionals<\/strong><\/p>\n\n\n\n<p>Paediatric Musculoskeletal Matters&nbsp;<a href=\"https:\/\/www.pmmonline.org\/doctor\/joint-pain-by-site\/foot-ankle-pain\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.pmmonline.org\/doctor\/joint-pain-by-site\/foot-ankle-pain<\/a><\/p>\n\n\n\n<iframe src=\"\/refhelp\/list-resources-and-links\/?post_id=8573\"><\/iframe>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Information Paediatric Flexible Flat Foot Flexible flat feet are normal variants caused by increased flexibility of the joints and ligaments of the foot. This is present in 90% of 1 year olds and up to 20% of adults. The arch of the foot usually takes up until 10 years of age to completely develop. Diagnosis<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[725],"class_list":["post-8573","page","type-page","status-publish","hentry","category-paediatric-flat-foot"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/podiatry\/msk-podiatry\/paediatric-flat-foot\/\" rel=\"tag\">Paediatric Flat Foot<\/a>","rttpg_excerpt":"Information Paediatric Flexible Flat Foot Flexible flat feet are normal variants caused by increased flexibility of the joints and ligaments of the foot. This is present in 90% of 1 year olds and up to 20% of adults. The arch of the foot usually takes up until 10 years of age to completely develop. Diagnosis","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8573","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=8573"}],"version-history":[{"count":2,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8573\/revisions"}],"predecessor-version":[{"id":14813,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/8573\/revisions\/14813"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=8573"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=8573"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}