Tags

Type your tag names separated by a space and hit enter

Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession: a retrospective study.
Foot Ankle Spec. 2013 Apr; 6(2):101-7.FA

Abstract

BACKGROUND

Flatfoot deformities are common in children and are treated using many conservative and surgical approaches. Subtalar extra-articular arthroereisis, in particular, limits talar motion, spares the subtalar joint, and prevents excessive subtalar joint pronation. Addressing the underlying equinus deformity with gastrocnemius recession is an important factor in optimizing outcomes in patients with flatfoot deformity.

METHODS

This study included 20 children, 4 to 17 years old. The patients presented 34 cases of functional flexible flatfoot, and each was treated with gastrocnemius recession and a subtalar implant insertion of either a resorbable arthroereisis plug constructed of poly-L lactic acid or a threaded titanium alloy plug. Clinical evaluation was based on the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale as well as subjective assessments of pain, function, shoe wear, and overall preoperative and postoperative satisfaction.

RESULTS

The average AOFAS Ankle-Hindfoot Scale reading improved by 21.3 points (standard deviation = 8.1; 95% confidence interval = 17.5-25.1), from an average preoperative reading of 67.7 points to an average postoperative reading of 89 points (P < .0001). Subjectively, patients experienced reduced pain and improved function, cosmesis, and shoe wear.

CONCLUSIONS

Treating equinus deformity with gastrocnemius recession significantly improved patient outcomes when treating flatfoot deformity. Reconstructive flatfoot surgery that combined subtalar arthroereisis with a resorbable arthroereisis plug and gastrocnemius recession resulted in favorable clinical outcomes and patient satisfaction. Symptom improvement and preservation of the subtalar joint were seen with these procedures, which are reasonable and useful options in treating children with symptomatic flexible flatfoot.

LEVELS OF EVIDENCE

Therapeutic, Level IV, Retrospective case series.

Authors+Show Affiliations

South Jersey Healthcare, Vineland, New Jersey, USA.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23263679

Citation

Jay, Richard M., and Nadia Din. "Correcting Pediatric Flatfoot With Subtalar Arthroereisis and Gastrocnemius Recession: a Retrospective Study." Foot & Ankle Specialist, vol. 6, no. 2, 2013, pp. 101-7.
Jay RM, Din N. Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession: a retrospective study. Foot Ankle Spec. 2013;6(2):101-7.
Jay, R. M., & Din, N. (2013). Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession: a retrospective study. Foot & Ankle Specialist, 6(2), 101-7. https://doi.org/10.1177/1938640012470714
Jay RM, Din N. Correcting Pediatric Flatfoot With Subtalar Arthroereisis and Gastrocnemius Recession: a Retrospective Study. Foot Ankle Spec. 2013;6(2):101-7. PubMed PMID: 23263679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession: a retrospective study. AU - Jay,Richard M, AU - Din,Nadia, Y1 - 2012/12/21/ PY - 2012/12/25/entrez PY - 2012/12/25/pubmed PY - 2013/10/1/medline SP - 101 EP - 7 JF - Foot & ankle specialist JO - Foot Ankle Spec VL - 6 IS - 2 N2 - BACKGROUND: Flatfoot deformities are common in children and are treated using many conservative and surgical approaches. Subtalar extra-articular arthroereisis, in particular, limits talar motion, spares the subtalar joint, and prevents excessive subtalar joint pronation. Addressing the underlying equinus deformity with gastrocnemius recession is an important factor in optimizing outcomes in patients with flatfoot deformity. METHODS: This study included 20 children, 4 to 17 years old. The patients presented 34 cases of functional flexible flatfoot, and each was treated with gastrocnemius recession and a subtalar implant insertion of either a resorbable arthroereisis plug constructed of poly-L lactic acid or a threaded titanium alloy plug. Clinical evaluation was based on the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale as well as subjective assessments of pain, function, shoe wear, and overall preoperative and postoperative satisfaction. RESULTS: The average AOFAS Ankle-Hindfoot Scale reading improved by 21.3 points (standard deviation = 8.1; 95% confidence interval = 17.5-25.1), from an average preoperative reading of 67.7 points to an average postoperative reading of 89 points (P < .0001). Subjectively, patients experienced reduced pain and improved function, cosmesis, and shoe wear. CONCLUSIONS: Treating equinus deformity with gastrocnemius recession significantly improved patient outcomes when treating flatfoot deformity. Reconstructive flatfoot surgery that combined subtalar arthroereisis with a resorbable arthroereisis plug and gastrocnemius recession resulted in favorable clinical outcomes and patient satisfaction. Symptom improvement and preservation of the subtalar joint were seen with these procedures, which are reasonable and useful options in treating children with symptomatic flexible flatfoot. LEVELS OF EVIDENCE: Therapeutic, Level IV, Retrospective case series. SN - 1938-7636 UR - https://www.unboundmedicine.com/medline/citation/23263679/Correcting_pediatric_flatfoot_with_subtalar_arthroereisis_and_gastrocnemius_recession:_a_retrospective_study_ L2 - http://journals.sagepub.com/doi/full/10.1177/1938640012470714?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -