How to approach the pediatric flatfoot.

The most difficult aspect regarding treatment of the pediatric flatfoot is understanding who needs surgery, when it is necessary, and what procedure to be done. A thorough history, clinical examination, and imaging should be performed to guide the surgeon through an often complex treatment path. Surgical technique can be divided in three categories: Soft tissue, bony, and arthroereisis. This paper will describe the joint preserving techniques and their application to treat the pediatric flatfoot deformity.