Clinical diagnosis and assessment of the pediatric pes planovalgus deformity.

The careful evaluation of the pediatric flatfoot begins with a detailed history and is followed by a thorough physical examination. Flatfeet may be congenital or acquired, and flexible or rigid. It is important to classify and evaluate a flatfoot, as the treatment recommendations depend on the assessment and proper diagnosis. The entire lower limb should be evaluated as a unit as one considers the suprapedal influences affecting foot position. The rigid flatfoot results in a fixed foot position that causes suprapedal compensation. On the other hand, most children presenting for evaluation of an acquired, flexible pes valgus deformity, with or without symptoms, will have abnormal, faulty biomechanical alignment of the lower extremity as the primary cause for an acquired, compensatory deformity of the foot.