الفهرس 
Anatomy of the Human FootOnly 14 pages are availabe for public view
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Abstract
F
latFoot (FF) is a common lower extremity condition in children. This condition includes misalignment of bones, joints and other structures supporting the medial longitudinal arch (MLA) and leads to abnormal pronation of the subtalar joint. However, there is no universally accepted radiographic or clinical definition for FF.
There has been flooding of information indicating the preventions and treatments, as well as the consequence of the FF condition from various sources, such as health professions, clinics, ‘healthy shoe’ companies and also people with no known qualification. While its exact etiology still remains unknown, different approaches on the management of the FF problem in children were found. A lot of confusions have been made by the media that threatened the parents to bring their kids to seek for orthotic interventions.
Since previous works demonstrated that foot types can affect foot function, the abnormal condition of Rigid Flat Foot (RFF) should be clearly differentiated from the normal variance in the first step. Literature and the public, however, have controversial approaches on how to define RFF.
Because of the disagreement on the definition, the prevalence of RFF varies from in different populations. A vast number of studies have made use of various static footprint measures to assess the foot or to classify foot types in terms of foot anthropometric measurements, footprint indices or angles.
Recently, researchers begin to elucidate that static and dynamic behaviours of the human foot are different. The biomechanics of the foot during gait, rather than the shape of the foot, is the most important consideration in treatment planning.
It has been revealed that FF is not only a static alignment problem but also results of dynamic functional changes of lower extremity. It has also been found that only 4% to 15 % of the arch height measurements could be reflected by the static footprints indices. Foot print parameters had no predictive power on the biological variability in bony or soft tissue of the foot.
After the abnormal feet in children have been differentiated, the treatment protocol should then be considered. There has been great deal of controversies in the literature about the treatment protocol for RFF. Some researchers believe that RFF is an anatomical variant that require treatment. On the contrary, other researchers postulate that orthotic interventions could induce positive changes to RFF in children in terms of plantar pressure distribution and joint kinematics. They also advocate diagnosing and treating the RFF in early childhood because it may cause debilitating foot pain in adulthood. If the treatment is helpful, many musculoskeletal abnormities related to RFF may also be prevented. Yet, no long-term prospective studies have been found on the natural history of the untreated RFF.
The problem in the literature is that only few studies have evaluated the conservative treatments for FF. At the same time, most of the studies neglect the fact that an effective orthotic treatment should be based on a series of systematic procedures which includes thorough and appropriate diagnostic clinical examinations, reliable foot impression procedure, foot model rectification method, objective orthotic design, correct fitting, and also followed by long-term evaluation of treatment outcomes. Many studies did not describe the design and the casting method in detail. This makes the researches not repeatable and as a result unverified.The baseline characteristics are usually not reported in the studies and thus make comparison impossible. Furthermore, literature usually focuses on the immediate biomechanical effects of foot orthoses in adults rather than the corrective effect of orthoses in children, there is very limited knowledge on how the interventions affect the development of foot arch in the growing children.
Since children’s feet undergo systematic changes and development during growth period, the development of the longitudinal foot arch maybe affected by extrinsic factors. Some researchers urge for a long-term investigation of foot orthotic treatment for rigid flat foot, therefore we tried to first address the growth patterns of the children, follow by thorough review of using dynamic footprint measurements and investigate the results of orthotic treatment in children with RFF, so that the robust conclusion of the effects of treatment of AFFF in children could be drawn.