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The Paediatric Foot

Edited by: Dr Angela Evans, Dr Stewart Morrison, Dr Cylie Williams, Guest editors: Angela M. Evans, Cylie M. Williams, Stewart C. Morrison

Making sense of the clinical challenges that manifest in the paediatric foot and lower limb is an evolving area of practice. In many areas of medicine and health care, evidence-based practice has grown in the last century, and continues to shape clinician’s understanding of paediatric lower limb conditions. In some instances, the contemporary evidence has presented contrary recommendations for practice. A crucial shift has been the management of the congenital paediatric clubfoot (talipes equino varus). Longitudinal observation and investigation has seen the non-surgical Ponseti method now adopted globally as ‘best practice’, largely relegating the surgical posterior medial release (PMR). How extraordinary that the inexpensive Ponseti method also provides the best clinical outcomes! Without observation, query, and the use of good scientific method, many children of the world with a clubfoot would remain either untreated, or surgically managed, often deleteriously.

The medical literature has a story to tell, but must be interpreted carefully, systematically, and fairly, if we are to make sense of it. Literature reviews make an, often unheralded, contribution to our body of knowledge and provide the platform from which further inquiry can begin. This special collection from selected articles published within Journal of Foot and Ankle Research, both exemplifies the emerging body of evidence and illustrates the current gaps in the evidence for common clinical presentations viz. calcaneal apophysitis (Sever’s disease), growing pains, flatfoot, and the impact of obesity.

Where to from here? The next decade requires more robust, systematic investigation of the paediatric foot and lower limb. We need: research designs for the collection of longitudinal data; query driven by public health initiatives; to utilise appropriate, well-designed methods; and outcome measures which are child-specific. Using evidence-based practice will ensure that children receive only those interventions that are demonstrably beneficial and necessary.

  1. Content type: Research

    Foot deformity, flat feet, and the use of ill-fitting footwear are common in children and adolescents with Down syndrome (DS). The aim of this study was to determine whether these observations are associated w...

    Authors: Polly QX Lim, Nora Shields, Nikolaos Nikolopoulos, Joanna T Barrett, Angela M Evans, Nicholas F Taylor and Shannon E Munteanu

    Citation: Journal of Foot and Ankle Research 2015 8:4

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  2. Content type: Methodology

    A number of multi-segment foot protocols have been proposed to obtain measurements of clinical value. In the clinical assessment of foot pathologies and deformities, such as in the pes-planus, the frontal-plan...

    Authors: Nicola Portinaro, Alberto Leardini, Artemisia Panou, Valerio Monzani and Paolo Caravaggi

    Citation: Journal of Foot and Ankle Research 2014 7:57

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  3. Content type: Research

    Chronic ankle instability (CAI) is a disabling condition often encountered after ankle injury. Three main components of CAI exist; perceived instability; mechanical instability (increased ankle ligament laxity...

    Authors: Melissa Mandarakas, Fereshteh Pourkazemi, Amy Sman, Joshua Burns and Claire E Hiller

    Citation: Journal of Foot and Ankle Research 2014 7:21

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  4. Content type: Research

    Various foot models are used in the analysis of foot motion during gait and selection of the appropriate model can be difficult. The clinical utility of a model is dependent on the repeatability of the data as...

    Authors: Ryan Mahaffey, Stewart C Morrison, Wendy I Drechsler and Mary C Cramp

    Citation: Journal of Foot and Ankle Research 2013 6:43

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  5. Content type: Research

    Childhood obesity is thought to predispose to structural foot changes and altered foot function. Little is currently understood about whether similar changes occur in overweight children. The aim of this study...

    Authors: Stephen D Cousins, Stewart C Morrison and Wendy I Drechsler

    Citation: Journal of Foot and Ankle Research 2013 6:36

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  6. Content type: Review

    Calcaneal apophysitis, also commonly known as sever’s disease, is a condition seen in children usually aged between 8–15 years. Conservative therapies, such as taping, heel lifts and orthotic intervention are ...

    Authors: Alicia M James, Cylie M Williams and Terry P Haines

    Citation: Journal of Foot and Ankle Research 2013 6:16

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  7. Content type: Research

    Thong style flip-flops are a popular form of footwear for children. Health professionals relate the wearing of thongs to foot pathology and deformity despite the lack of quantitative evidence to support or ref...

    Authors: Angus Chard, Andrew Greene, Adrienne Hunt, Benedicte Vanwanseele and Richard Smith

    Citation: Journal of Foot and Ankle Research 2013 6:8

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  8. Content type: Research

    Plantar pressure assessment can provide information pertaining to the dynamic loading of the foot, as well as information specific to each region in contact with the ground. There have been few studies which h...

    Authors: Stephen D Cousins, Stewart C Morrison and Wendy I Drechsler

    Citation: Journal of Foot and Ankle Research 2012 5:8

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  9. Content type: Research

    Outcome measures are important when evaluating treatments and physiological progress in paediatric populations. Reliable, relevant measures of foot posture are important for such assessments to be accurate ove...

    Authors: Angela M Evans, Keith Rome and Lauren Peet

    Citation: Journal of Foot and Ankle Research 2012 5:1

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  10. Content type: Research

    The effect of footwear on the gait of children is poorly understood. This systematic review synthesises the evidence of the biomechanical effects of shoes on children during walking and running.

    Authors: Caleb Wegener, Adrienne E Hunt, Benedicte Vanwanseele, Joshua Burns and Richard M Smith

    Citation: Journal of Foot and Ankle Research 2011 4:3

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  11. Content type: Review

    It is generally understood that toe walking involves the absence or limitation of heel strike in the contact phase of the gait cycle. Toe walking has been identified as a symptom of disease processes, trauma a...

    Authors: Cylie M Williams, Paul Tinley and Michael Curtin

    Citation: Journal of Foot and Ankle Research 2010 3:16

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  12. Content type: Study protocol

    Posterior Heel pain can present in children of 8 to 14 years, associated with or clinically diagnosed as Sever's disease, or calcaneal apophysitis. Presently, there are no comparative randomised studies evalua...

    Authors: Alicia M James, Cylie M Williams and Terry P Haines

    Citation: Journal of Foot and Ankle Research 2010 3:3

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  13. Content type: Research

    Concern about a child's flat foot posture is a common reason for frequent clinical consultations for an array of health care and medical professionals. The recently developed paediatric flatfoot clinical-care ...

    Authors: Angela Margaret Evans, Hollie Nicholson and Noami Zakarias

    Citation: Journal of Foot and Ankle Research 2009 2:25

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