Evidence-based pediatric podiatry: literature review and update

Abstract

Introduction: Pediatric podiatry has become established as an essential discipline in the comprehensive approach to the developing child. Alterations in the morphology and functionality of the children's foot, such as flexible flatfoot, are frequent reasons for consultation and require careful evaluation based on scientific evidence. Objective: This narrative review aims to analyze the evolution of knowledge on the anatomy and physiology of the children's foot, identify the prevalent podiatric conditions in childhood, review the main therapeutic interventions available and update the role of the podiatrist in the current clinical context. Methods. A search for information was carried out in the period May - July 2025, in the databases SciELO, Scopus, PubMed / MedLine, the Google Scholar search engine, Cochrane Library, as well as in the Clinical Keys services. Only those studies of the type systematic reviews, meta-analyses, randomized controlled trials (RCTs), controlled clinical trials (CCTs), observational studies and cross-sectional designs were selected. Results: Evidence shows that most cases of flexible flatfoot in childhood are physiological and do not require treatment, except in the presence of symptoms. Foot orthoses, functional re-education exercises, and appropriate footwear have proven effective in selected cases. In particular, intrinsic muscle strengthening programs have shown improvements in the plantar arch and gait. Current clinical practice remains variable, making ongoing training and the adoption of standardized protocols crucial. Conclusions: Timely, individualized, and evidence-guided intervention can prevent long-term musculoskeletal complications, improve locomotor function, and contribute to a better quality of life in childhood. The role of the pediatric podiatrist should be integrated into the multidisciplinary team for a comprehensive approach to child development.