Flexible flatfoot in children has been thought to be either an anatomic variant related to ligamentous laxity or a precursor to a painful problem with the foot in adulthood that should be vigorously treated during early childhood. Children (N = 129) ages 1 to 6 years who had flexible flat feet in this study were assigned prospectively to treatment with corrective shoes, heel-cups, or a "custom-molded plastic insert," or were assigned as controls. The diagnosis was based on clinical examination (heel valgus, poor arch formation) and radiographic criteria. The children were followed for an average of 3 years; mean age upon entry into the study was approximately 2 years.

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