Painful idiopathic rigid flatfoot in children and adolescents

Nine patients (13 feet) were identified whose primary complaints were of at raumatic-onset, chronic pain in the hindfoot exacerbated with increased act ivity and who had the diagnosis of idiopathic rigid flatfeet. Eight of 11 w ere greater than the 95(th) percentile in weight for their age. Exam under anesthesia showed moderate to significant improvement in hindfoot motion in 9 feet; 4 feet required fractional peroneal lengthenings. Only 5 of 11 pat ients have had sustained relief of pain and report unlimited activity level . Children and adolescents with painful idiopathic rigid flatfeet without kno wn causation can have significant, persistent, disability and do not unifor mly respond well to traditionally-described nonoperative interventions.