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Abstract
Pes planovalgus by convention refers to loss of the medial longitudinal arch of the foot. Other anatomical abnormalities may be present as well, such as a valgus position of the heel, mild subluxation of the subtalar joint, abduction at the midtarsal joint and supination of the forefoot relative to the hindfoot. It is important to note that all children under 5 years of age have a depressed medial longitudinal arch because of the low calcaneal inclination angle. (1)
Pes planovalgus may exist as an isolated pathology or as part of a larger clinical entity. These clinical entities include generalized ligamentous laxity, neurologic and muscular abnormalities, genetic conditions and collagen disorders. (2)
Pes planovalgus is very common in children and the incidence among children varies from 2.8% to 24.2%. (3)
Pediatric pes planovalgus can be divided into flexible and rigid categories. Flexible pes planovalgus is characterized by a normal arch during non weight bearing and a flattening of the arch on stance. Flexible pes planovalgus may be asymptomatic or symptomatic. Rigid pes planovalgus is characterized by a stiff, flattened arch on and off weight bearing.
Most rigid pes planovalgus are associated with underlying pathology that requires special consideration. Skewfoot is an uncommon disorder characterized by severe pronation of the rearfoot and an adductovarus