Fuentes-Venado Claudia E, Ángeles-Ayala Aranza, Salcedo-Trejo Montserrat S, Sumano-Pérez Leticia J, Valle Claudia Y Viveros-Del, Martínez-Herrera Erick O, León María G Frías-de, González-Gutiérrez Leopoldo E, Monjaras-Bernal Isis G, Pinto-Almazán Rodolfo
Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de México. México.
Unidad de Investigación Médica en Farmacología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México. México.
Bol Med Hosp Infant Mex. 2020;77(6):312-319. doi: 10.24875/BMHIM.20000135.
The increase or reduction of the medial longitudinal arch (MLA) can affect essential functions in the foot biomechanics with long-term health consequences. The aim of the present study was to determine the height of the MLA in children from 3 to 6 years of age through five methods of footprint analysis for the diagnosis of flat foot.
A cross-sectional observational study was conducted with 367 children aged 3 to 6 years in a municipality of the State of Mexico. We conducted a complete postural evaluation, plantoscopy by Viladot classification, and footprint analysis calculating the height of the ALM using the Clarke angle (CA), the Staheli index (SI), the Chippaux-Smirak index (CSM), and the gamma angle (gA).
The prevalence of flat feet using the podoscope was 57.7%. Through the angles and indexes, the prevalence was 86.9% for SI, 83.3% for CSI, 95.9% for CA, and 22.3% for gA. The gA was less sensitive for flat foot detection compared to CSI, SI and CA.
Based on the present results, we propose that footprint analysis should be used for flat foot diagnosis besides the classic evaluation by podoscope. We recommend that flat foot diagnosis and surveillance should be included on in the consultation of the healthy child, as a trend for podalic architecture can be detected from early ages.
内侧纵弓（MLA）的增高或降低会影响足部生物力学的基本功能，并产生长期健康后果。本研究的目的是通过五种足迹分析方法确定3至6岁儿童的MLA高度，以诊断扁平足。
在墨西哥州的一个城市对367名3至6岁儿童进行了横断面观察研究。我们进行了全面的姿势评估、根据维拉多特分类法进行足底检查，并通过计算克拉克角（CA）、斯塔赫利指数（SI）、奇波-斯米拉克斯指数（CSM）和伽马角（gA）来分析足迹，以计算ALM的高度。
使用足诊镜诊断扁平足的患病率为57.7%。通过角度和指数分析，SI的患病率为86.9%，CSI为83.3%，CA为95.9%，gA为22.3%。与CSI、SI和CA相比，gA对扁平足检测的敏感性较低。
基于目前的结果，我们建议除了通过足诊镜进行经典评估外，还应使用足迹分析来诊断扁平足。我们建议在健康儿童的咨询中纳入扁平足的诊断和监测，因为从早期就可以检测到足部结构的变化趋势。
