Determining treatment of flatfeet in children.

Infants are born with flexible flatfeet, and the normal arch develops in the first decade of life. Flexible flatfeet rarely cause disability, and asymptomatic children should not be burdened with orthotics or corrective shoes. Flexible flatfeet with tight heelcords may become symptomatic and can be addressed with a stretching program. Surgical intervention for flexible flatfeet is reserved for patients who have persistent localized symptoms despite conservative care. Rigid or pathologic flatfeet have multiple etiologies and many will require treatment to alleviate symptoms or improve function.