Wagner F, Hofbauer R, Matussek J
Orthopädische Klinik, Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077 Bad Abbach, Deutschland.
Orthopade. 2013 Jun;42(6):455-68. doi: 10.1007/s00132-013-2111-3.
Flexible flatfoot in childhood is a common cause for repetitive consultations and the diagnosis is verified by the clinical examination. In most cases the findings are age-dependent variants of the norm and if asymptomatic there is no need for treatment. In the first decade of life symptomatic flexible flatfoot should initially be treated with shoe inserts. Further diagnostic steps are required once conservative treatment is unsuccessful or a rigid structural deformity is found in the clinical examination. The underlying reasons may be neuropathic or structural anatomical in origin. Lateral column lengthening as described by Evans or minimally invasive arthroereisis are well established surgical options but for arthroereisis the number of long-term studies is low. In general the indications for surgical and conservative therapy have to be judged with caution although parents often see an urgent need for treatment.
儿童柔韧性扁平足是反复就诊的常见原因，临床检查可确诊。大多数情况下，检查结果是正常的年龄相关变异，若无症状则无需治疗。在生命的第一个十年中，有症状的柔韧性扁平足最初应使用鞋垫治疗。一旦保守治疗失败或临床检查发现僵硬的结构性畸形，则需要进一步的诊断步骤。其潜在原因可能是神经性或结构性解剖学原因。Evans描述的外侧柱延长术或微创关节制动术是成熟的手术选择，但对于关节制动术，长期研究数量较少。一般来说，手术和保守治疗的适应症必须谨慎判断，尽管家长往往迫切需要治疗。
