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Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity.
Foot Ankle Surg. 2020 Jan; 26(1):98-104.FA

Abstract

BACKGROUND

Pediatric flexible flatfoot is sometimes asymptomatic but it can rarely cause physical impairment, pain, and difficulty walking. We evaluated the radiographic effectiveness of intervention of subtalar arthroereisis with endorthesis for pediatric flexible flatfoot with final follow-up at skeletal maturity.

METHODS

This is a retrospective cross-sectional study. 56 consecutive patients (112 feet) who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot (mean age at final follow-up 15.5±1.2 years, 39.3% female) were enrolled. All the radiographic studies were performed in the hospital. Radiographs (standard weight-bearing radiographs of the foot with anteroposterior and lateral view) were used to measure lateral talocalcaneal angle (LTC), calcaneal pitch angle (CP), Meary's angle (MA), anteroposterior talonavicular angle (APTN), talonavicular uncoverage percent (TNU). Minimum follow-up was 18 months. Measures were assessed pre-operatively and at the final follow-up. Clinical and functional parameters were assessed at the final follow-up.

RESULTS

Children who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot exhibited a statistically significant improvement in all radiographic measurement parameters at the last follow-up at skeletal maturity (all, p<0.004). Mean follow-up was 40.1±23.6months. Clinical parameters were not correlated with the foot radiographic parameters at follow up period.

CONCLUSIONS

Our results suggest that endorthesis in pediatric flexible flatfoot was effective for improving radiographic parameters at skeletal maturity. The amount of the morphologic correction at the end of the skeletal growth should be expected mainly for lateral tarso-metatarsal alignment and talo-navicular congruency (MA, APTN, TNU).

LEVEL OF EVIDENCE

Level III, retrospective study.

Authors+Show Affiliations

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: cristian.indino@gmail.com.IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. Electronic address: mail@villafane.it.IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Università degli Studi di Milano, Italy. Electronic address: riccardo.dambrosi@hormail.it.IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: luigimanzi@alice.it.IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Università degli Studi di Milano, Italy. Electronic address: camillamaccario@gmail.com.IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: pberjano@gmail.com.IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Electronic address: fusuelli@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30598422

Citation

Indino, Cristian, et al. "Effectiveness of Subtalar Arthroereisis With Endorthesis for Pediatric Flexible Flat Foot: a Retrospective Cross-sectional Study With Final Follow Up at Skeletal Maturity." Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, vol. 26, no. 1, 2020, pp. 98-104.
Indino C, Villafañe JH, D'Ambrosi R, et al. Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity. Foot Ankle Surg. 2020;26(1):98-104.
Indino, C., Villafañe, J. H., D'Ambrosi, R., Manzi, L., Maccario, C., Berjano, P., & Usuelli, F. G. (2020). Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity. Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, 26(1), 98-104. https://doi.org/10.1016/j.fas.2018.12.002
Indino C, et al. Effectiveness of Subtalar Arthroereisis With Endorthesis for Pediatric Flexible Flat Foot: a Retrospective Cross-sectional Study With Final Follow Up at Skeletal Maturity. Foot Ankle Surg. 2020;26(1):98-104. PubMed PMID: 30598422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity. AU - Indino,Cristian, AU - Villafañe,Jorge Hugo, AU - D'Ambrosi,Riccardo, AU - Manzi,Luigi, AU - Maccario,Camilla, AU - Berjano,Pedro, AU - Usuelli,Federico Giuseppe, Y1 - 2018/12/21/ PY - 2017/10/16/received PY - 2018/06/15/revised PY - 2018/12/09/accepted PY - 2019/1/2/pubmed PY - 2020/8/25/medline PY - 2019/1/2/entrez KW - Arthroereisis KW - Endorthesis KW - Foot KW - Pediatric SP - 98 EP - 104 JF - Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons JO - Foot Ankle Surg VL - 26 IS - 1 N2 - BACKGROUND: Pediatric flexible flatfoot is sometimes asymptomatic but it can rarely cause physical impairment, pain, and difficulty walking. We evaluated the radiographic effectiveness of intervention of subtalar arthroereisis with endorthesis for pediatric flexible flatfoot with final follow-up at skeletal maturity. METHODS: This is a retrospective cross-sectional study. 56 consecutive patients (112 feet) who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot (mean age at final follow-up 15.5±1.2 years, 39.3% female) were enrolled. All the radiographic studies were performed in the hospital. Radiographs (standard weight-bearing radiographs of the foot with anteroposterior and lateral view) were used to measure lateral talocalcaneal angle (LTC), calcaneal pitch angle (CP), Meary's angle (MA), anteroposterior talonavicular angle (APTN), talonavicular uncoverage percent (TNU). Minimum follow-up was 18 months. Measures were assessed pre-operatively and at the final follow-up. Clinical and functional parameters were assessed at the final follow-up. RESULTS: Children who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot exhibited a statistically significant improvement in all radiographic measurement parameters at the last follow-up at skeletal maturity (all, p<0.004). Mean follow-up was 40.1±23.6months. Clinical parameters were not correlated with the foot radiographic parameters at follow up period. CONCLUSIONS: Our results suggest that endorthesis in pediatric flexible flatfoot was effective for improving radiographic parameters at skeletal maturity. The amount of the morphologic correction at the end of the skeletal growth should be expected mainly for lateral tarso-metatarsal alignment and talo-navicular congruency (MA, APTN, TNU). LEVEL OF EVIDENCE: Level III, retrospective study. SN - 1460-9584 UR - https://www.unboundmedicine.com/medline/citation/30598422/Effectiveness_of_subtalar_arthroereisis_with_endorthesis_for_pediatric_flexible_flat_foot:_a_retrospective_cross_sectional_study_with_final_follow_up_at_skeletal_maturity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1268-7731(18)30505-8 DB - PRIME DP - Unbound Medicine ER -