{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T23:33:40Z","timestamp":1794440020712,"version":"4.9.1"},"reference-count":33,"publisher":"SLACK, Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:p>The goal of this study was to provide measures of symptoms and signs in a consecutive case series of children with flexible flatfoot based on a systematic clinical approach. Fifty-three children (age range, 10\u201314 years) previously diagnosed with flexible flatfoot were evaluated by a structured interview and clinical assessment. Most patients had foot symptoms (65.3% of feet) and functional limitation (68.3%). Symptoms included a sensation of discomfort (11.3%), such as early tiredness or difficulties during prolonged standing or walking, and pain (54%), mostly located in the plantar aspect of the foot (28.7%) and the medial hindfoot (18.8%). Body mass index was positively correlated to the presence of symptoms and their severity.<\/jats:p>\n                  <jats:p>Even if an enlarged footprint was present in 93.1% of feet, objective assessment evidenced the presence of heel valgus only in 83% of feet. Forefoot adduction was present in 22% of feet. Jack\u2019s test provided varus correction in only 54% of feet. Internal knee rotation was the most common associated disalignment, present in 43.6% of limbs. Symptoms were significantly correlated to knee alignment, and functional limitation was correlated to heel valgus. Standing balance on 1 leg was significantly correlated to footprint grading severity.<\/jats:p>\n                  <jats:p>A systematic clinical approach to assess children with flexible flatfoot should always be recommended for the correct diagnosis and the associated treatment management based on symptoms, functional limitation, and foot dysfunction. Functional assessment by specific tests should be included in the examination, as evidence exists that morphology and function are not necessarily related.<\/jats:p>","DOI":"10.3928\/01477447-20101221-04","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T12:00:54Z","timestamp":1539604854000},"source":"Crossref","is-referenced-by-count":61,"title":["Diagnosis of Flexible Flatfoot in Children: A Systematic Clinical Approach"],"prefix":"10.3928","volume":"34","author":[{"given":"Maria Grazia","family":"Benedetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ceccarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Berti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deianira","family":"Luciani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Catani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Boschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Giannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.09.013"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-199802000-00016"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200100022-00003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199111000-00010"},{"key":"e_1_3_2_6_2","first-page":"1","volume-title":"Army foot survey. An investigation of foot ailments in Canadian soldiers","author":"Harris RI","year":"1947","unstructured":"Harris RI, Beath T. Army foot survey. An investigation of foot ailments in Canadian soldiers. Ottawa, Ontario: National Research Council of Canada; 1947:1\u2013268."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070202300108"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2262"},{"key":"e_1_3_2_9_2","first-page":"1371","volume-title":"Disorders of the Foot and Ankle","author":"Bateman JE","year":"1991","unstructured":"Bateman JE. The adult heel. In: , Jhass MH, ed. Disorders of the Foot and Ankle. Philadelphia, PA: Saunders; 1991:1371\u20131381."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(09)80043-4"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-88-5-206"},{"issue":"3","key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0742-0668(23)00031-6","article-title":"Developmental flatfoot","volume":"1","author":"D\u2019Amico JC","year":"1984","unstructured":"D\u2019Amico JC. Developmental flatfoot. Clin Podiatry. 1984; 1(3):535\u2013546.","journal-title":"Clin Podiatry"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079701800208"},{"issue":"3","key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S1083-7515(24)00061-5","article-title":"The flexible flatfoot","author":"Giannini S","year":"1998","unstructured":"Giannini S, Ceccarelli F. The flexible flatfoot. Foot Ankle Clin. 1998; (3):573\u2013592.","journal-title":"Foot Ankle Clin"},{"key":"e_1_3_2_15_2","first-page":"1333","volume-title":"Disorders of the Foot and Ankle","author":"Jhass MH","year":"1991","unstructured":"Jhass MH. The subtalar complex. In: , Jhass MH, ed. Disorders of the Foot and Ankle. Philadelphia, PA: Saunders; 1991:1333\u20131371."},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110078800800609"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-200105000-00022"},{"key":"e_1_3_2_18_2","volume-title":"Normal and Abnormal Function of the Foot","author":"Root ML","year":"1977","unstructured":"Root ML, Orien WP, Weed JH. Normal and Abnormal Function of the Foot. Vol 2. Los Angeles, CA: Clinical Biomechanics Corporation; 1977."},{"issue":"181","key":"e_1_3_2_19_2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/00003086-198312000-00011","article-title":"Flat feet in children","author":"Barry RJ","year":"1983","unstructured":"Barry RJ, Scranton PE. Flat feet in children. Clin Orthop Relat Res. 1983; (181):68\u201375.","journal-title":"Clin Orthop Relat Res"},{"issue":"181","key":"e_1_3_2_20_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/00003086-198312000-00003","article-title":"Hypermobile flatfoot in children. Comprehension, evaluation, and treatment","author":"Bordelon RL","year":"1983","unstructured":"Bordelon RL. Hypermobile flatfoot in children. Comprehension, evaluation, and treatment. Clin Orthop Relat Res. 1983; (181):7\u201314.","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(01)00151-5"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-199909000-00019"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(98)90099-7"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000208"},{"issue":"11","key":"e_1_3_2_25_2","first-page":"1264","article-title":"Effects of arch height of the foot on ground reaction forces in running","volume":"24","author":"Nachbauer W","year":"1992","unstructured":"Nachbauer W, Nigg BM. Effects of arch height of the foot on ground reaction forces in running. Med Sci Sports Exerc. 1992; 24(11):1264\u20131269.","journal-title":"Med Sci Sports Exerc"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.67B1.3968149"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9290(96)00136-4"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)90884-8"},{"key":"e_1_3_2_29_2","first-page":"69","volume-title":"Quince lecciones sobre patologia del ped","author":"Viladot R","year":"1989","unstructured":"Viladot R, Rochera R, Viladot A. Quince lecciones sobre patologia del ped. Barcelona, Spain: Ediciones Toray SA; 1989:69\u201393."},{"key":"e_1_3_2_30_2","volume-title":"Musculoskeletal Assessment: Range of Motion and Manual Muscle Strength","author":"Clarkson HM","year":"1989","unstructured":"Clarkson HM, Gilewich GB. Musculoskeletal Assessment: Range of Motion and Manual Muscle Strength. Baltimore, MD: Williams & Wilkins; 1989."},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-194830010-00013"},{"issue":"2","key":"e_1_3_2_32_2","first-page":"259","article-title":"Normal limits of knee angle in white children\u2014genu varum and genu valgum","volume":"13","author":"Heath CH","year":"1993","unstructured":"Heath CH, Staheli LT. Normal limits of knee angle in white children\u2014genu varum and genu valgum. J Pediatr Orthop. 1993; 13(2):259\u2013262.","journal-title":"J Pediatr Orthop"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110070002100910"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000809"}],"container-title":["Orthopedics"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T20:04:52Z","timestamp":1775246692000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.healio.com\/doi\/10.3928\/01477447-20101221-04"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,2]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,2]]}},"alternative-id":["10.3928\/01477447-20101221-04"],"URL":"https:\/\/doi.org\/10.3928\/01477447-20101221-04","relation":{},"ISSN":["0147-7447","1938-2367"],"issn-type":[{"value":"0147-7447","type":"print"},{"value":"1938-2367","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,2]]},"article-number":"01477447-20101221-04"}}