Foot and ankle problems in children and young people: a population-based cohort study

Aim: The aim of this research is to describe the epidemiology, presentation and healthcare use in primary care for foot and ankle problems in children and young people (CYP) across England. Methods: This was a population-based cohort study using data from the Clinical Practice Research Datalink Aurum database, a database of anonymised electronic health records from general practices across England. Data was accessed for all children and young people aged 0–18 years presenting to their General Practitioner between January 2015 and December 2021 with a foot and/or ankle problem. Consultation rates were calculated and used to estimate numbers of consultations in an average practice. Hierarchical Poisson regression estimated relative rates of consultations across sociodemographic groups and logistic regression evaluated factors associated with repeat consultations. Results: 416,137 patients had 687,753 foot and ankle events, of which the majority were categorised “musculoskeletal” (34%), and “unspecified pain” (21%). Rates peaked at 601 consultations per 10,000 patient years among males aged 10-14 years in 2018. An average practice might observe 132 (95% CI 110 to 155) consultations annually. Odds for repeat consultations were higher among those with pre-existing diagnoses including juvenile arthritis (OR 1.73, 95%CI 1.48 to 2.03). Conclusions: Consultations for these problems are high among CYP, particularly males aged 10 to 14 years. These data can inform service provision to ensure CYP access appropriate health professionals for accurate diagnosis and treatment.