Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study

Introduction: Flatfoot, or pes planus, is a postural deformity resulting from the inadequate development of the Medial Longitudinal Arch (MLA) of the foot. Generalised ligament laxity is the most important aetiological factor among various predisposing factors. Previous research has explored these c...

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Main Authors: Ashish Yadav, Shalu Arimbooth, Avinash Muraleedharan, Shweta Chaubey
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-01-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20520/73829_CE(Ra1)_F(Sh)_QC(PS_SS)_PF1(AG_SS)_PFA(OM)_PB(AG_IS)_PN(IS).pdf
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author Ashish Yadav
Shalu Arimbooth
Avinash Muraleedharan
Shweta Chaubey
author_facet Ashish Yadav
Shalu Arimbooth
Avinash Muraleedharan
Shweta Chaubey
author_sort Ashish Yadav
collection DOAJ
description Introduction: Flatfoot, or pes planus, is a postural deformity resulting from the inadequate development of the Medial Longitudinal Arch (MLA) of the foot. Generalised ligament laxity is the most important aetiological factor among various predisposing factors. Previous research has explored these conditions independently rather than investigating their potential association. This study focuses on understanding how generalised ligament laxity contributes to flexible flatfoot, which could provide valuable insights that have not been thoroughly explored in paediatric and adolescent populations. Aim: To determine the association between flexible flatfoot and generalised ligament laxity in paediatric and adolescent populations. Materials and Methods: This case-control study was conducted on 180 patients attending the Physical Medicine and Rehabilitation (PMR) Outpatient Department (OPD), aged 5 to 19 years, from September 2019 to March 2021. Footprints were taken from the subjects and a flatfoot assessment was performed using Staheli’s plantar arch index. The Jack test was conducted in all flatfoot subjects to exclude rigid flatfoot. All patients with flexible flatfoot were enrolled as cases, while those without flatfoot were enrolled in the control group. Both groups were further evaluated using the Beighton Score for the presence of generalised ligament laxity and results were recorded. Demographic factors were expressed as frequencies, and quantitative data were presented as median with 25th and 75th percentiles (IQR=interquartile range). Differences in qualitative variables between the groups were analysed using the Chi-square test. Results: Out of the 180 subjects, 126 (70%) were male, and the majority, 108 (60%), were aged 11 to 19 years, with a mean ± SD age of 11.46±3.1 years. The proportion of ligament laxity was higher in cases 30 (41.67%) than in controls 20 (18.52%), and this association was statistically significant (p-value=0.016). Patients with flatfoot had a 3.14 times higher chance of having ligament laxity than those lacking flatfoot, which was statistically significant. Conclusion: Children and adolescents with increased generalised ligament laxity are more predisposed to the development of flexible flatfoot compared to those without ligament laxity.
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spelling doaj-art-6b32a88a604e40f1ac8258bae7e34b742025-01-23T11:57:50ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-01-011901131610.7860/JCDR/2025/73829.20520Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control StudyAshish Yadav0Shalu Arimbooth1Avinash Muraleedharan2Shweta Chaubey3Senior Resident, Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.Senior Resident, Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Mangalagiri, Vijayawada, Andhra Pradesh, India.Senior Resident, Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Raipur, Chattisgarh, India.Consultant, Department of Physical Medicine and Rehabilitation, Baptist Hospital, Bangalore, Karnataka, IndiaIntroduction: Flatfoot, or pes planus, is a postural deformity resulting from the inadequate development of the Medial Longitudinal Arch (MLA) of the foot. Generalised ligament laxity is the most important aetiological factor among various predisposing factors. Previous research has explored these conditions independently rather than investigating their potential association. This study focuses on understanding how generalised ligament laxity contributes to flexible flatfoot, which could provide valuable insights that have not been thoroughly explored in paediatric and adolescent populations. Aim: To determine the association between flexible flatfoot and generalised ligament laxity in paediatric and adolescent populations. Materials and Methods: This case-control study was conducted on 180 patients attending the Physical Medicine and Rehabilitation (PMR) Outpatient Department (OPD), aged 5 to 19 years, from September 2019 to March 2021. Footprints were taken from the subjects and a flatfoot assessment was performed using Staheli’s plantar arch index. The Jack test was conducted in all flatfoot subjects to exclude rigid flatfoot. All patients with flexible flatfoot were enrolled as cases, while those without flatfoot were enrolled in the control group. Both groups were further evaluated using the Beighton Score for the presence of generalised ligament laxity and results were recorded. Demographic factors were expressed as frequencies, and quantitative data were presented as median with 25th and 75th percentiles (IQR=interquartile range). Differences in qualitative variables between the groups were analysed using the Chi-square test. Results: Out of the 180 subjects, 126 (70%) were male, and the majority, 108 (60%), were aged 11 to 19 years, with a mean ± SD age of 11.46±3.1 years. The proportion of ligament laxity was higher in cases 30 (41.67%) than in controls 20 (18.52%), and this association was statistically significant (p-value=0.016). Patients with flatfoot had a 3.14 times higher chance of having ligament laxity than those lacking flatfoot, which was statistically significant. Conclusion: Children and adolescents with increased generalised ligament laxity are more predisposed to the development of flexible flatfoot compared to those without ligament laxity.https://jcdr.net/articles/PDF/20520/73829_CE(Ra1)_F(Sh)_QC(PS_SS)_PF1(AG_SS)_PFA(OM)_PB(AG_IS)_PN(IS).pdffootprinthypermobilityjoint flexibilitymedial longitudinal archpes planusplantar arch
spellingShingle Ashish Yadav
Shalu Arimbooth
Avinash Muraleedharan
Shweta Chaubey
Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
Journal of Clinical and Diagnostic Research
footprint
hypermobility
joint flexibility
medial longitudinal arch
pes planus
plantar arch
title Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
title_full Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
title_fullStr Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
title_full_unstemmed Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
title_short Exploring the Link between Generalised Ligament Laxity and Flexible Flatfoot in Paediatric and Adolescent Populations: A Case-control Study
title_sort exploring the link between generalised ligament laxity and flexible flatfoot in paediatric and adolescent populations a case control study
topic footprint
hypermobility
joint flexibility
medial longitudinal arch
pes planus
plantar arch
url https://jcdr.net/articles/PDF/20520/73829_CE(Ra1)_F(Sh)_QC(PS_SS)_PF1(AG_SS)_PFA(OM)_PB(AG_IS)_PN(IS).pdf
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AT shaluarimbooth exploringthelinkbetweengeneralisedligamentlaxityandflexibleflatfootinpaediatricandadolescentpopulationsacasecontrolstudy
AT avinashmuraleedharan exploringthelinkbetweengeneralisedligamentlaxityandflexibleflatfootinpaediatricandadolescentpopulationsacasecontrolstudy
AT shwetachaubey exploringthelinkbetweengeneralisedligamentlaxityandflexibleflatfootinpaediatricandadolescentpopulationsacasecontrolstudy