儿童柔韧性扁平足的诊断及防治研究进展

张进; 姜淑云; 李阳; 俞艳; 鲁潇莹; 李一瀛

doi:10.16835/j.cnki.1000-9817.2023.06.034

儿童柔韧性扁平足的诊断及防治研究进展

doi: 10.16835/j.cnki.1000-9817.2023.06.034

张进^{1, 2},
姜淑云^1, ,,
李阳¹,
俞艳¹,
鲁潇莹¹,
李一瀛¹

1.
上海中医药大学附属岳阳中西医结合医院步态与运动分析中心，上海 200041
2.
上海中医药大学岳阳临床医学院

基金项目:

国家自然科学基金 82105040

上海市科技创新新行动计划软科学重点项目(青年) 20692193800

上海市卫生健康委员会卫生行业临床研究专项 20194Y0024

详细信息

作者简介:
张进(1995-)，男，江苏宿迁人，在读硕士，主要研究方向为小儿推拿及步态分析

通讯作者:
姜淑云，E-mail: yadancoo@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G804.49
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-21
- 修回日期: 2022-12-11
- 网络出版日期: 2023-06-28
- 刊出日期: 2023-06-25

Advantes in diagnosis, prevention and treatment of flexible flatfoot in children

ZHANG Jin^{1, 2},
JIANG Shuyun^{1
, ,},
LI Yang¹,
YU Yan¹,
LU Xiaoying¹,
LI Yiying¹

1.
Centre for Gait and Movement Analysis, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai(200041), China

摘要

摘要: 柔韧性扁平足是扁平足的一个重要分类，早期的柔韧性扁平足为生理状态，若6岁以后仍不能发育形成正常足弓则为病理状态。此时如不及时干预，将对儿童青少年运动发育健康造成极大危害；及时发现与干预是改善柔韧性扁平足预后的关键。关于柔韧性扁平足的诊断还缺乏统一的量化标准，目前常用诊断方法包括体格检查、足印法、足底压力测试以及影像学检查。本文对柔韧性扁平足的危险因素、诊断、预防以及治疗方法进行综述。
- 扁平足 /
- 诊断 /
- 危险因素 /
- 儿童
Abstract: Flexibleis an important classification of flat foot. Flatfoot occurs due to a variety of reasons and causes the medial longitudinal arch to collapse or disappear. However, many children still do not develop a normal foot arch as the grow, and a failure to intervene in a timely manner will greatly harm a child's normal mobility development. Timely detection and intervention are the key to improve the prognosis. There is a lack of uniform quantitative criteria for the diagnosis of flexible flatfoot. Currently, the commonly used diagnostic methods include physical examination, foot printing, plantar pressure test and imaging examination. This article reviews the risk factors, diagnosis, prevention and treatment of Flexible Flatfoot.
- Flatfoot /
- Diagnosis /
- Risk factors /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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参考文献(50)

[1]	BANWELL H A, PARIS M E, MACKINTOSH S, et al. Paediatric flexible flat foot: how are we measuring it and are we getting it right?A systematic review[J]. J Foot Ankle Res, 2018, 11: 21. doi: 10.1186/s13047-018-0264-3
[2]	TURNER C, GARDINER M D, MIDGLEY A, et al. A guide to the management of paediatric pes planus[J]. Aust J Gen Pract, 2020, 49(5): 245-249. doi: 10.31128/AJGP-09-19-5089
[3]	CARR J N, YANG S, LATHER L A. Pediatric pes planus: a state-of-the-art review[J]. Pediatrics, 2016, 137(3): e20151230. doi: 10.1542/peds.2015-1230
[4]	KANATL U, AKTAS E, YETKIN H. Do corrective shoes improve the development of the medial longitudinal arch in children with flexible flat feet?[J]. J Orthop Sci Offic, 2016, 21(5): 662-666. doi: 10.1016/j.jos.2016.04.014
[5]	FORD S E, SCANNELL B P. Pediatric flatfoot: pearls and pitfalls[J]. Foot Ankle Clin, 2017, 22(3): 643-656. doi: 10.1016/j.fcl.2017.04.008
[6]	HELL A K, DODERLEIN L, EBERHARDT O, et al. S2-Guideline: pediatric flat foot[J]. Z Orthop Unfall, 2018, 156(3): 306-315. doi: 10.1055/s-0044-101066
[7]	YIN J C, ZHAO H M, ZHUANG G H, et al. Flexible flatfoot of 6-13-year-old children: a cross-sectional study[J]. J Orthop Sci, 2018, 23(3): 552-556. doi: 10.1016/j.jos.2018.02.004
[8]	TENENBAUM S, HERSHKOVICH O, GORDON B, et al. Flexible pes planus in adolescents: body mass index, body height, and gender: an epidemiological study[J]. Foot Ankle Int, 2013, 34(6): 811-817. doi: 10.1177/1071100712472327
[9]	SHEIKH T A, FELDMAN D S. Painful flexible flatfoot[J]. Foot Ankle Clin, 2015, 20(4): 693-704. doi: 10.1016/j.fcl.2015.07.011
[10]	BASTIAS G F, DALMAU-PASTOR M, ASTUDILLO C, et al. Spring ligament instability[J]. Foot Ankle Clin, 2018, 23(4): 659-678. doi: 10.1016/j.fcl.2018.07.012
[11]	KIMURA Y, YAMASHIRO T, SAITO Y, et al. MRI findings of spring ligament injury: association with surgical findings and flatfoot deformity[J]. Acta Radiol Open, 2020, 9(12): 1739875663.
[12]	FARRIS D J, KELLY L A, CRESSWELL A G, et al. The functional importance of human foot muscles for bipedal locomotion[J]. Proc Natl Acad Sci USA, 2019, 116(5): 1645-1650. doi: 10.1073/pnas.1812820116
[13]	OKAMURA K, FUKUDA K, OKI S, et al. Effects of plantar intrinsic foot muscle strengthening exercise on static and dynamic foot kinematics: a pilot randomized controlled single-blind trial in individuals with pes planus[J]. Gait Posture, 2020, 75: 40-45. doi: 10.1016/j.gaitpost.2019.09.030
[14]	MCKEON P O, FOURCHET F. Freeing the foot: integrating the foot core system into rehabilitation for lower extremity injuries[J]. Clin Sports Med, 2015, 34(2): 347-361. doi: 10.1016/j.csm.2014.12.002
[15]	HOLLANDER K, DE VILLIERS J E, SEHNER S, et al. Growing-up (habitually) barefoot influences the development of foot and arch morphology in children and adolescents[J]. Sci Rep, 2017, 7(1): 8079. doi: 10.1038/s41598-017-07868-4
[16]	陈莉, 姜淑云, 俞艳, 等. 儿童柔韧性平足的研究进展[J]. 中国康复, 2019, 34(7): 386-389. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLKF201907020.htm CHEN L, JIANG S Y, YU Y, et al. Research progress of flexible flatfoot in children[J]. Chin J Rehabil, 2019, 34(7): 386-389. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLKF201907020.htm
[17]	BERKELEY R, TENNANT S, SAIFUDDIN A. Multimodality imaging of the paediatric flatfoot[J]. Skeletal Radiol, 2021, 50(11): 2133-2149. doi: 10.1007/s00256-021-03806-8
[18]	ADHIKARI U, ARULSINGH W, PAI G. Normative values of navicular drop test and the effect of demographic parameters-a cross sectional study[J]. Ann Biol Res, 2014, 5(7): 40-48.
[19]	EVANS A M, NICHOLSON H, ZAKARIAS N. The paediatric flat foot proforma(p-FFP): improved and abridged following a reproducibility study[J]. J Foot Ankle Res, 2009, 2: 25. doi: 10.1186/1757-1146-2-25
[20]	DREFU L, KEDEM P, MANGAN S, et al. Reliability of the arch height index as a measure of foot structure in children[J]. Pediatr Phys Ther, 2017, 29(1): 83-88. doi: 10.1097/PEP.0000000000000337
[21]	PITA-FERNÁNDEZ S, GONZÁLEZ-MARTÍN C, SEOANE-PILLADO T, et al. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older[J]. J Epidemiol, 2015, 25(2): 148-154. doi: 10.2188/jea.JE20140082
[22]	GIJON-NOGUERON G, MARCHENA-RODRIGUEZ A, MONTES-ALGUACIL J, et al. Evaluation of the paediatric foot using footprints and foot posture index: a cross-sectional study[J]. J Paediatr Child Health, 2020, 56(2): 201-206. doi: 10.1111/jpc.14558
[23]	汤运启, 邹灵秋, 李毅, 等. 儿童足型分类方法的系统综述[J]. 中国组织工程研究, 2022, 26(12): 1963-1968. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202212029.htm TANG Y Q, ZOU L Q, LI Y, et al. A systematic review of children's foot type classification methods[J]. J Clin Rehabil Tis Eng Res, 2022, 26(12): 1963-1968. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF202212029.htm
[24]	ABOELNASR E A, HEGAZY F A, ZAGHLOUL A A, et al. Validation of normalized truncated navicular height as a clinical assessment measure of static foot posture to determine flatfoot in children and adolescents: a cross sectional study[J]. Foot (Edinb), 2018, 37: 85-90. doi: 10.1016/j.foot.2018.05.001
[25]	NAGY M, KHOLEIF A, MANSOUR A, et al. Comparison between Malerba osteotomy and combined evans/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: a prospective randomised control trial, three years follow-up[J]. Int Orthop, 2021, 45(10): 2579-2588. doi: 10.1007/s00264-021-05172-5
[26]	De MAIO F, PISANO C, CATERINI A, et al. Orthopaedic aspects in seventy-two children affected by Marfan syndrome. Correlations between pathological features and fibrillin-1 gene mutations[J]. J Biol Regul Homeost Agents, 2020, 34(5): 69-73.
[27]	TAHRIRIAN M A, RAMTIN S, TAHERI P. Functional and radiographic comparison of subtalar arthroereisis and lateral calcaneal lengthening in the surgical treatment of flexible flatfoot in children[J]. Int Orthop, 2021, 45(9): 2291-2298. doi: 10.1007/s00264-020-04899-x
[28]	SUH D H, KIM H J, PARK J H, et al. Relationship between hallux valgus and pes planus in adult patients[J]. J Foot Ankle Surg, 2021, 60(2): 297-301. doi: 10.1053/j.jfas.2020.06.030
[29]	李海, 张海瑞, 张瀚元, 等. 扁平足检测方法研究及进展[J]. 中国卫生标准管理, 2018, 9(9): 34-37. https://www.cnki.com.cn/Article/CJFDTOTAL-WSBZ201809016.htm LI H, ZHANG H R, ZHANG H Y, et al. Study on detection methods and progress of flatfoot[J]. Chin Health Stand Manage, 2018, 9(9): 34-37. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSBZ201809016.htm
[30]	HOSL M, BOHM H, MULTERER C, et al. Does excessive flatfoot deformity affect function?A comparison between symptomatic and asymptomatic flatfeet using the oxford foot model[J]. Gait Posture, 2014, 39(1): 23-28. doi: 10.1016/j.gaitpost.2013.05.017
[31]	KIM H Y, SHIN H S, KO J H, et al. Gait analysis of symptomatic flatfoot in children: an observational study[J]. Clin Orthop Surg, 2017, 9(3): 363-373. doi: 10.4055/cios.2017.9.3.363
[32]	TAKABAYASHI T, EDAMA M, INAI T, et al. Differences in rearfoot, midfoot, and forefoot kinematics of normal foot and flatfoot during running[J]. J Orthop Res, 2021, 39(3): 565-571. doi: 10.1002/jor.24877
[33]	CARR J N, YANG S, LATHER L A. Pediatric pes planus: a state-of-the-art review[J]. Pediatrics, 2016, 137(3): e20151230. doi: 10.1542/peds.2015-1230
[34]	何智捷, 姜淑云, 张韶辉, 等. 儿童柔韧性扁平足康复治疗的研究进展[J]. 中华物理医学与康复杂志, 2021, 43(10): 957-960. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS202207011.htm HE Z J, JIANG S Y, ZHANG S H, et al. Research progress in rehabilitaton of flexible flatfoot in children[J]. Chin J Phys Med Rehabil, 2021, 43(10): 957-960. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS202207011.htm
[35]	TURNER C, GARDINER M, MIDGLEY A. A guide to the management of paediatric pes planus[J]. Austr J Gener Pract, 2020, 49(5): 245-249. doi: 10.31128/AJGP-09-19-5089
[36]	HU C W, DABNICHKI P, BACA A, et al. Preventive strategy of flatfoot deformity using fully automated procedure[J]. Med Eng Phys, 2021, 95: 15-24. doi: 10.1016/j.medengphy.2021.07.006
[37]	DARS S, UDEN H, BANWELL H, et al. The effectiveness of non-surgical intervention (footorthoses) for paediatric flexible pes planus: a systematic review: update[J]. PLoS One, 2018, 13(2): e0193060. doi: 10.1371/journal.pone.0193060
[38]	HSIEH R L, PENG H L, LEE W C. Short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children: a randomized controlled trial[J]. Medicine(Baltimore), 2018, 97(20): e10655.
[39]	ABOUTORABI A, SAEEDI H, KAMALI M, et al. Immediate effect of orthopedic shoe and functional foot orthosis on center of pressure displacement and gait parameters in juvenile flexible flat foot[J]. Prosthet Orthot Int, 2014, 38(3): 218-223. doi: 10.1177/0309364613496111
[40]	LIN K W, HU C J, YANG W W, et al. Biomechanical evaluation and strength test of 3d-printed foot orthoses[J]. Appl Bionics Biomech, 2019, 2019: 4989534.
[41]	UNVER B, ERDEM E U, AKBAS E. Effects of short-foot exercises on foot posture, pain, disability, and plantar pressure in pes planus[J]. J Sport Rehabil, 2020, 29(4): 436-440. doi: 10.1123/jsr.2018-0363
[42]	KIM T, PARK J C. Short-term effects of sports taping on navicular height, navicular drop and peak plantar pressure in healthy elite athletes: a within-subject comparison[J]. Medicine(Baltimore), 2017, 96(46): e8714.
[43]	CHOI I R, LEE J H. The effect of the application direction of the kinesiology tape on the strength of fatigued quadriceps muscles in athletes[J]. Res Sports Med, 2019, 27(1): 1-10. doi: 10.1080/15438627.2018.1502187
[44]	SIU W S, SHIH Y F, LIN H C. Effects of Kinesio tape on supporting medial foot arch in runners with functional flatfoot: a preliminary study[J]. Res Sports Med, 2020, 28(2): 168-180. doi: 10.1080/15438627.2019.1638258
[45]	YELVERTON C, RAMA S, ZIPFEL B. Manual therapy interventions in the treatment of plantar fasciitis: a comparison of three approaches[J]. Health SA, 2019, 24: 1244.
[46]	BAC A, KACZOR S, PASIUT S, et al. The influence of myofascial release on pain and selected indicators of flat foot in adults: a controlled randomized trial[J]. Sci Rep, 2022, 12(1): 1414. doi: 10.1038/s41598-022-05401-w
[47]	陈瑞巧, 梁燕清, 李玉红. 生长发育儿童扁平足的分析及手法矫治[J]. 中国实用医药, 2017, 12(18): 36-37. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201718016.htm CHEN R Q, LIANG Y Q, LI Y H. Analysis and manipulation correction for children flatfoot at growth and development period[J]. Chin Pract Med, 2017, 12(18): 36-37. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201718016.htm
[48]	DANA C, PEJIN Z, CADILHAC C, et al. Long-term results of the "horseman" procedure for severe idiopathic flatfoot in children: a retrospective analysis of 41 consecutive cases with mean 8.9 year duration of follow-up[J]. J Foot Ankle Surg, 2019, 58(1): 10-16. doi: 10.1053/j.jfas.2018.05.008
[49]	刘冠杰, 韩煜, 赵康成, 等. 距下关节制动术治疗柔韧性扁平足的历史与现状[J]. 中国矫形外科杂志, 2018, 26(1): 52-55. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS201801015.htm LIU G J, HAN Y, ZHAO K C, et al. History and current status of subtalar arthrodesis for flexible flatfoot[J]. Orthop J Chin, 2018, 26(1): 52-55. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXS201801015.htm
[50]	林旭裕, 王凯波, 蔡树辉, 等. 距下关节制动术在治疗儿童柔韧性扁平足中的矫形效果[J]. 深圳中西医结合杂志, 2020, 30(2): 105-106. https://www.cnki.com.cn/Article/CJFDTOTAL-SZZX202002052.htm LIN X Y, WANG K B, CAI S H, et al. Orthotic effect of subtalar arthrodesis in the treatment of flexible flatfoot in children[J]. Shenzhen J Integrated Traditl Chin West Med, 2020, 30(2): 105-106. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SZZX202002052.htm