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Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up.
J Foot Ankle Surg. 2019 Sep; 58(5):904-915.JF

Abstract

The purpose of this study is to recognize those young patients with symptomatic flexible flatfoot deformity who need treatment and to provide radiological evidence that arthroereisis is capable of relocating the talus properly over the calcaneus. We included 28 feet in 14 children who underwent subtalar arthroereisis in association with percutaneous triple-hemisection Achilles tendon lengthening. Selected for arthroereisis were children with symptomatic flexible flatfoot deformity who complained of foot and leg pain, had decreased endurance in sports activities and long walks, who did not respond to conservative treatment modalities for at least 6 months, and in whom at radiological assessment on stance position with the medial arch support orthosis the talonavicular joint lateral subluxation still remained, with Meary's angle in anteroposterior (A/P) and lateral view remaining increased. The mean age at surgery was 10.71 ± 1.58 (range 8 to 14) years. The minimum follow-up duration was 19 months, with mean follow-up duration of 35.14 ± 9.82 (range 19 to 60) months. For estimation of the efficacy of the surgical procedure, the American Orthopaedic Foot and Ankle Society (AFOAS) rating scale was used preoperatively and postoperatively in all patients. The mean preoperative AFOAS ankle-hind foot rating score was 65.14 ± 7.16 (range 58 to 75) points. The mean postoperative AFOAS score was 88.851 ± 5.61 (range 83 to 97) points and the 2-tailed p value <.0001. After arthroereisis surgical treatment, all AOFAS scores and all foot angles improved significantly, except the calcaneal inclination angle which improved slightly.

Authors+Show Affiliations

Consultant Pediatric Orthopaedic Surgeon, Orthopaedic Department, Athens Children's Hospital "P. & A. Kyriakou," Athens, Greece. Electronic address: megremispanos@yahoo.com.Community Doctor, Department of Medicine, National and Kapodistrial University of Athens, Athens, Greece.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31474401

Citation

Megremis, Panos, and Orestis Megremis. "Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up." The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, vol. 58, no. 5, 2019, pp. 904-915.
Megremis P, Megremis O. Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up. J Foot Ankle Surg. 2019;58(5):904-915.
Megremis, P., & Megremis, O. (2019). Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up. The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, 58(5), 904-915. https://doi.org/10.1053/j.jfas.2019.01.012
Megremis P, Megremis O. Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up. J Foot Ankle Surg. 2019;58(5):904-915. PubMed PMID: 31474401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroereisis for Symptomatic Flexible Flatfoot Deformity in Young Children: Radiological Assessment and Short-Term Follow-Up. AU - Megremis,Panos, AU - Megremis,Orestis, PY - 2018/05/01/received PY - 2019/9/3/entrez PY - 2019/9/3/pubmed PY - 2019/9/3/medline KW - heel KW - joint KW - pediatric KW - subtalar KW - talonavicular KW - tendon SP - 904 EP - 915 JF - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons JO - J Foot Ankle Surg VL - 58 IS - 5 N2 - The purpose of this study is to recognize those young patients with symptomatic flexible flatfoot deformity who need treatment and to provide radiological evidence that arthroereisis is capable of relocating the talus properly over the calcaneus. We included 28 feet in 14 children who underwent subtalar arthroereisis in association with percutaneous triple-hemisection Achilles tendon lengthening. Selected for arthroereisis were children with symptomatic flexible flatfoot deformity who complained of foot and leg pain, had decreased endurance in sports activities and long walks, who did not respond to conservative treatment modalities for at least 6 months, and in whom at radiological assessment on stance position with the medial arch support orthosis the talonavicular joint lateral subluxation still remained, with Meary's angle in anteroposterior (A/P) and lateral view remaining increased. The mean age at surgery was 10.71 ± 1.58 (range 8 to 14) years. The minimum follow-up duration was 19 months, with mean follow-up duration of 35.14 ± 9.82 (range 19 to 60) months. For estimation of the efficacy of the surgical procedure, the American Orthopaedic Foot and Ankle Society (AFOAS) rating scale was used preoperatively and postoperatively in all patients. The mean preoperative AFOAS ankle-hind foot rating score was 65.14 ± 7.16 (range 58 to 75) points. The mean postoperative AFOAS score was 88.851 ± 5.61 (range 83 to 97) points and the 2-tailed p value <.0001. After arthroereisis surgical treatment, all AOFAS scores and all foot angles improved significantly, except the calcaneal inclination angle which improved slightly. SN - 1542-2224 UR - https://www.unboundmedicine.com/medline/citation/31474401/Arthroereisis_for_Symptomatic_Flexible_Flatfoot_Deformity_in_Young_Children:_Radiological_Assessment_and_Short_Term_Follow_Up_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1067-2516(19)30015-8 DB - PRIME DP - Unbound Medicine ER -