Procedure
Variant 1
- The child sits on the parent’s lap [Figure 152].
- In this resting position (foot in plantar flexion), inspect the medial arch of both feet.
- If you observe a concave medial arch, then the foot has corrected itself and the flat feet are said to be flexible.
Figure 152
Variant 2
- Ask the child to stand on their toes [Figure 153].
- During this plantar flexion position, inspect the arches of both feet.
- If you see a concave medial arch develop, the foot has corrected itself and the flat feet are said to be flexible.
Figure 153
Variant 3
- Hubscher’s test (see examination of the foot and ankle).
The Tarsal Coalition
This foot abnormality is characterised by an abnormal connection between two bones in the root of the foot. In 90% of cases, it concerns a coalition between the navicular bone and the calcaneus and/or between the talus and the calcaneus. Often, there are also defects in the talocrural joint, as a result of which valgus and varus tilt in this joint are possible.
Pain symptoms mostly manifest in the root of the foot, but also along the length of the peroneal musculature. During physical examination, inversion and eversion are found to be marked limited. Usual therapeutic possibilities comprise immobilisation in plaster or excision of the coalition.