Does severity of the flatfoot deformity affect pain and mobility in adolescents with symptomatic flatfoot

Abstract

Flexible flatfoot is a prevalent pediatric condition, with some cases resulting in pain and mobility limitations necessitating surgical intervention such as calcaneal lengthening osteotomy (CLO). The relationship between flexible flatfoot severity, BMI, and symptomats remains unclear. The study aims to investigate the association between the severity of flexible flatfoot deformity and BMI with pain and mobility impairment in children undergoing CLO. A retrospective database of pediatric patients with symptomatic flexible flatfoot treated with CLO was analyzed. Preoperative pain and mobility were assessed using Patient Reported Outcome Measurement Information System (PROMIS) scores. The severity of flexible flatfoot was determined by weight-bearing anteroposterior and lateral talo-first metatarsal angles. We included 57 patients with an average age of 12.18 years. The average preoperative PROMIS pain score was 53.76, and the mobility score was 41.27. No significant relationship was found between the severity of deformity and PROMIS scores for pain. Similarly, obesity did not significantly affect pain or mobility scores. In children with symptomatic flexible flatfoot undergoing CLO, neither the severity of the deformity nor obesity significantly influenced preoperative pain and mobility as measured by PROMIS scores. These findings suggest that factors other than the severity of flexible flatfoot deformity and obesity may contribute to the symptoms in this patient population. Level of evidence: Level III.