Hefti F, Brunner R
Kinderorthopädische Universitätsklinik, Universitäts-Kinderspital beider Basel, Germany.
Orthopade. 1999 Mar;28(2):159-172. doi: 10.1007/PL00003593.
Many parents are anxious because of the insufficient arch of the feet of their children. A true congenital deformity (congenital vertical talus) is extremely rare. In children the arch is physiologically flattened with a hypervalgus of the hindfoot. Those feet do not need treatment. If there is no medial recess in the footprint in a child over 3 years of age, then we are talking about a flexible flatfoot. When the load of the foot is more pronounced at the medial rather than at the lateral side, operative treatment can be indicated, such as a lengthening osteotomy of the calcaneum. If the flatfoot is rigid, the reason for it is usually a tarsal coalition. Operative transection of the osseous bridge with fat interposition can solve the problem. Flatfeet may also occur in neuromuscular diseases. Depending on the severity of the deformity, splints can be effective, or - in the more severe cases - operative treatement such as a triple arthodesis can be indicated.
许多家长因孩子足弓不足而焦虑。真正的先天性畸形（先天性垂直距骨）极为罕见。在儿童中，足弓在生理上是扁平的，后足有外翻。这些脚不需要治疗。如果3岁以上儿童的足底印记中没有内侧凹陷，那么就是柔性扁平足。当足部内侧而非外侧的负重更明显时，可考虑手术治疗，如跟骨延长截骨术。如果扁平足是僵硬型的，其原因通常是跗骨联合。通过骨桥切断并植入脂肪的手术可以解决问题。扁平足也可能发生在神经肌肉疾病中。根据畸形的严重程度，夹板可能有效，或者在更严重的情况下，可考虑手术治疗，如三关节融合术。
