Treatment of pediatric flatfoot: a systematic review-based consensus and guidelines by CPAM-LRC
By
Sharula
Fei Zhao
Tianyi Wu
Qinglin Kang
Xiang Geng
Hui Qin
Yan Zhang
Jin He
Lihua Huang
Jia Xu
Shengdi Lu
May 8, 2026
Clinical Scorecard: Guidelines and Consensus for Managing Pediatric Flexible Flatfoot: A Systematic Review by the CPAM-LRC
At a Glance
Category Detail
Condition Pediatric Flexible Flatfoot Key Mechanisms Conservative and surgical interventions including observation, rehabilitative exercises, foot orthoses, subtalar arthroereisis, and calcaneal osteotomy. Target Population Children and teenagers with flexible flatfoot. Care Setting Orthopedic clinics, pediatric practices, rehabilitation centers.
Key Highlights
Structured conservative management is the mainstay of care for symptomatic children. A minimum 6-month trial of conservative treatment is recommended before surgical referral. Foot orthoses may provide symptomatic relief; rehabilitative exercises may enhance outcomes. Pain-free ambulation and return to unrestricted sport are key treatment milestones. No validated criteria exist for transitioning between treatment phases. Guideline-Based Recommendations
Diagnosis
Standardized diagnostic definitions are needed for pediatric flatfoot. Management
Conservative management should be prioritized; surgical options should be considered after a trial of nonoperative care. Monitoring & Follow-up
Regular assessment of symptoms and functional limitations is essential during treatment. Risks
Limited evidence on the optimal type, dose, and duration of conservative treatment. Patient & Prescribing Data
Children and teenagers with symptomatic flexible flatfoot.
Combination of conservative management and surgical options based on individual assessment.
Clinical Best Practices
Engage in multidisciplinary care involving orthopedic surgeons, podiatrists, and rehabilitation specialists. Utilize a trial of conservative management before considering surgical intervention. Document and standardize treatment pathways to reduce practice variation. Related Resources & Content
