International Journal of Medical Sciences And Clinical Research
72
https://theusajournals.com/index.php/ijmscr
VOLUME
Vol.05 Issue01 2025
PAGE NO.
72-74
10.37547/ijmscr/Volume05Issue01-11
Comparative analysis of traditional and comprehensive
methods of flatfoot treatment in children
Zokirkhojaev M.A.
Resident physician in the traumatology department, clinic of the Tashkent Pediatric Medical Institute, Uzbekistan
Received:
20 October 2024;
Accepted:
29 December 2024;
Published:
30 January 2025
Abstract:
Relevance. Flatfoot is a common orthopedic pathology in children that disrupts foot biomechanics and
gait. Its highest prevalence is observed at the age of 4
–
7 years, requiring early diagnosis and timely correction.
Objective. To assess the prevalence, clinical characteristics, and effectiveness of treatment methods for pediatric
flatfoot.
Results. Among 1,427 examined children, 12.8% were diagnosed with flatfoot, with 62.8% of cases occurring
between 4 and 7 years of age. Comprehensive treatment (physical therapy, massage, physiotherapy, orthopedic
devices) proved more effective (54.5% improvement) compared to traditional methods (39%). In children over 8
years old, treatment effectiveness declined.
Conclusion. Early diagnosis and a comprehensive treatment approach yield better outcomes, slowing disease
progression and reducing the risk of complications.
Findings. Flatfoot is most frequently diagnosed at 4
–
7 years, highlighting the need for active prevention and early
therapy. Comprehensive methods outperform traditional approaches, especially for moderate and severe cases.
Keywords:
Flatfoot, children, diagnosis, treatment, orthopedics, physiotherapy, prevention.
Introduction:
Flatfoot in children is one of the most
common orthopedic pathologies, affecting the
musculoskeletal
system
and
overall
physical
development of the child. According to conducted
studies, among 1,427 examined children aged 1 to 14
years, flatfoot was identified in 12.8% of cases,
indicating a significant prevalence of this condition
[1,7].
Early diagnosis and timely treatment of flatfoot are
crucial, as the lack of correction can lead to severe
consequences, including persistent gait disorders,
deformation of the lower limb joints and spine, chronic
pain development, and reduced quality of life for the
child [2,3].
This study is particularly relevant in the context of
selecting the most effective diagnostic and treatment
methods [4]. A comparative analysis of traditional and
comprehensive treatment approaches allows for the
assessment of thei
r effectiveness based on the child’s
age and the severity of the pathology [5,6,8].
Additionally, studying the age-related characteristics of
the disease is of great importance. It has been found
that the highest incidence of flatfoot occurs between
the ages of 4 and 7, highlighting the need for special
attention to preventive and therapeutic measures
during this period [3,7]. It is essential to consider that
flatfoot correction is most effective at an early age,
whereas treatment in older age groups becomes more
challenging and requires prolonged rehabilitation [2].
Thus, the study of flatfoot in children, its diagnosis, age-
related progression, and the effectiveness of various
treatment methods are pressing issues in modern
pediatric orthopedics. These efforts aim to enhance
prevention, early detection, and correction of this
pathology.
Research Objective
The aim of this study is to examine the characteristics
of diagnosis, frequency, and severity of flatfoot in
children, as well as to evaluate the effectiveness of
various treatment methods to optimize the correction
International Journal of Medical Sciences And Clinical Research
73
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
of this pathology.
METHODS
The study was conducted between 2014 and 2024 in
medical and educational institutions, including the
clinic of the Tashkent Pediatric Medical Institute. A
total of 1,427 children (aged 1
–
14 years) who
underwent orthopedic examinations were included in
the research.
The diagnosis of flatfoot was based on a clinical-
functional examination, which included visual foot
assessment, gait analysis, the use of plantography,
podometry, and radiography. Patients with flatfoot
(n=182) were divided into two groups: 94 children
received traditional treatment (massage, therapeutic
exercises, orthopedic footwear), while 88 underwent
comprehensive therapy with individualized correction
methods.
The effectiveness of treatment was assessed based on
clinical progress, symptom regression, and the degree
of deformity correction, considering the child's age and
severity of the pathology. A control group (n=1,245)
consisted of orthopedically healthy children. Statistical
analysis was used to identify patterns in flatfoot
development, evaluate treatment effectiveness, and
determine optimal prevention strategies.
RESULTS
In this study, 1,427 children aged 1
–
14 years were
examined, of whom 182 (12.8%) were diagnosed with
flatfoot of varying severity. Gender distribution analysis
showed that the condition was slightly more common
in boys (56.6%, n=103) than in girls (43.4%, n=79). The
highest prevalence was observed in children aged 4
–
7
years (62.8%, n=59), corresponding to the period of
arch formation, highlighting the need for timely
diagnosis and prevention. In the 1
–
3-year-old group,
flatfoot was diagnosed in 12.8% of cases (n=12), while
in children aged 8
–
14 years, the prevalence was 24.4%
(n=23).
The assessment of disease severity revealed that Grade
I flatfoot was present in 25.5% of patients (n=47),
Grade II in 50.0% (n=91), and the most severe Grade III
in 24.5% (n=44). With increasing age, there was a trend
toward more severe pathological changes, associated
with progressive musculoskeletal deformation and
reduced compensatory mechanisms.
To evaluate the effectiveness of different treatment
approaches, patients were divided into two groups: 94
children received traditional treatment (massage,
therapeutic exercises, orthopedic insoles, and
footwear), while 88 underwent comprehensive
therapy, including physiotherapy, individualized
exercises,
and
manual
correction.
Treatment
effectiveness was assessed in three age categories: 1
–
3 years, 4
–
7 years, and 8
–
14 years.
1
–
3 years: Traditional therapy showed positive results
in 25% of cases, while 41.7% of patients improved from
Grade III to Grade II. However, 33.3% showed no
significant improvement. The most effective methods
in this group were massage, physiotherapy, and
vitamin therapy, which contributed to the proper
development of the foot arch.
4
–
7 years: Complete resolution of flatfoot was
observed in 39% of children, while 32.2% showed
improvement by progressing to a milder grade. In 6.8%
of cases, patients with Grade III improved to Grade II.
However, 22% of children showed no significant
improvement. The best results were achieved through
a combination of therapeutic exercises, orthopedic
insoles, and massage.
8
–
14 years: Treatment effectiveness was the lowest in
this age group. Complete correction was observed in
84.6% of children with Grade I flatfoot. Among those
with Grade II, 66.7% showed improvement, though not
full recovery. In contrast, 66.7% of patients with Grade
III exhibited no significant changes. This can be
attributed to the decreased plasticity of bones and
ligaments in older children, making correction more
challenging and requiring longer treatment durations.
The overall assessment of effectiveness showed that in
the traditional treatment group, positive dynamics
were observed in 39% of patients, while 22% showed
no improvement. In the comprehensive treatment
group, 54.5% of children experienced improvement,
whereas 16.7% showed no significant effect.
Comprehensive methods proved to be more effective,
particularly in younger patients, confirming the
importance of early detection and correction of
flatfoot.
Additionally, 51.6% of children with flatfoot (n=94) had
associated orthopedic disorders, including joint
hypermobility (n=21), hallux valgus (n=16), calcaneal
osteochondropathy (n=8), and talus subluxations (n=6),
requiring additional corrective measures.
Thus, the study confirmed that flatfoot is a common
pathology among children, most frequently diagnosed
between the ages of 4 and 7. The highest treatment
effectiveness is achieved with early detection and
correction, especially before the age of 7, when active
foot arch formation is still possible. Comprehensive
treatment methods demonstrated better outcomes
compared to traditional approaches, particularly in
cases of Grade I and II flatfoot. In older children,
treatment requires a longer duration and rarely results
in complete deformity correction, emphasizing the
importance of preventive measures and timely
International Journal of Medical Sciences And Clinical Research
74
https://theusajournals.com/index.php/ijmscr
International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
orthopedic intervention.
Conclusion
The results of this study confirmed the high prevalence
of flatfoot among children, especially between the ages
of 4 and 7, due to active growth and musculoskeletal
development processes. The identified prevalence rate
(12.8%) highlights the need for early detection and a
comprehensive diagnostic approach to determine the
severity and nature of foot deformities.
An analysis of age-related disease progression
demonstrated that the highest treatment effectiveness
is achieved in younger age groups when the anatomical
and functional structures of the foot remain highly
plastic. In children aged 1
–
3 years, timely correction
can prevent persistent changes, while in children aged
4
–
7 years, the use of therapeutic exercises, orthopedic
devices, and massage yields positive results in most
cases.
In the 8
–
14 age group, treatment effectiveness
decreases due to significant morphological changes in
bones, ligaments, and joints, necessitating prolonged
rehabilitation. These
findings
underscore
the
importance of preventive measures and timely
orthopedic interventions to improve the outcomes of
flatfoot management in children.
A comparative assessment of therapy methods
demonstrated that traditional approaches, including
massage, therapeutic exercises, and the use of
orthopedic footwear, were primarily effective for
Grade I flatfoot. In contrast, comprehensive methods
that combined individualized exercise therapy
programs,
physiotherapy
procedures,
and
biomechanical foot correction achieved better
outcomes, especially for more severe forms of flatfoot.
Thus, the study confirmed the importance of early
diagnosis and timely treatment of flatfoot in children,
as well as the need to develop individualized
therapeutic programs considering the chil
d’s age and
the severity of the pathology. Optimizing treatment
strategies and implementing a comprehensive
approach to the correction of this orthopedic condition
can significantly improve treatment effectiveness,
reduce the risk of complications, and enh
ance patients’
quality of life.
CONCLUSIONS
The conducted study confirmed the high prevalence of
flatfoot in children, with a peak incidence between the
ages of 4 and 7, highlighting the need for early
diagnosis and timely correction. A comprehensive
approach, including therapeutic exercises, massage,
physiotherapy, and orthopedic devices, demonstrated
the highest effectiveness, particularly for Grade II and
III flatfoot.
It was established that children aged 1
–
3 years respond
best to correction, whereas treatment for patients
aged 8
–
14 years requires a more prolonged and
intensive approach. The study also identified
associated orthopedic conditions, emphasizing the
importance of comprehensive examination.
The obtained data justify the necessity of individualized
preventive and therapeutic programs to reduce the risk
of persistent foot deformities and improve gait
biomechanics.
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