Comparison of the Calcaneo-Cuboid-Cuneiform Osteotomies and the Calcaneal Lengthening Osteotomy in the Surgical Treatment of Symptomatic Flexible Flatfoot

Moraleda, Luis; Salcedo, M.; Bastrom, Tracey P.; Wenger, Dennis R.; Albiñana, Javier; Mubarak, Scott J.

doi:10.1097/bpo.0b013e3182648c74

Cited by 62 publications

(49 citation statements)

References 25 publications

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“…Other surgical interventions affecting the CP and MA, such as the more invasive calcaneal lengthening osteotomy, have reported comparable or even better radiological outcomes than the present technique. 25,[34][35][36] In 2015, Chong et al 37 conducted a nonrandomized comparative study in which subtalar arthroereisis and lateral column lengthening were compared in painful flatfeet in children. They observed comparable improvements on postoperative radiological outcomes and American Orthopaedic Foot and Ankle Society scores (AOFAS) for both techniques.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Bot

Stevens

Hermus

et al. 2019

Foot & Ankle Specialist

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Background. The purpose of this study is to evaluate functional and radiological outcomes of subtalar arthroereisis in the treatment of symptomatic pediatric flexible flatfeet. Methods. A total of 16 patients (26 feet) were treated with a Kalix II as subtalar motion blocker between 2009 and 2014. Calcaneal pitch (CP) and Meary’s angle (MA) were measured on radiographs preoperatively, directly postoperatively, and at follow-up 47 ± 17 (range 19-79) months. Patient satisfaction surveys were used to assess functional outcome and patient satisfaction. Results. Surgery was performed mostly for pain, walking problems, or a combination of both at a mean age of 12.5 ± 1.5 (range 10-15) years. Symptoms were relieved in 62.5% of patients in the postoperative phase and increased to 68.75% at follow-up. A statistically significant increase in CP of 2.8° and decrease in MA of 14.0° was observed directly postoperatively, which persisted during the follow-up period irrespective of Kalix removal. Revision surgery was necessary in 6 cases (23%) because of arthroereisis migration. Conclusion. Subtalar Kalix II arthroereisis significantly reduced clinical symptoms and improved the CP and MA directly postoperatively, which persisted during follow-up, irrespective of Kalix removal. Therefore, subtalar arthroereisis is a considerable intervention to reduce symptoms in children with symptomatic flexible flatfeet. Levels of Evidence: Level IV: Case series

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Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Bot

Stevens

Hermus

et al. 2019

Foot & Ankle Specialist

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“…51 The postsurgical results of a Triple-C osteotomy also have been overall favorable from a clinical and radiographic evaluation, although these results have been observational without the support of a control group. 52,53 Overall, positive outcomes after surgical management are possible when performed on the appropriate patient. A recent study by Oh et al 54 Arthroereisis is a nonfusion type of procedure in which the motion of a joint is restricted though not fully eliminated.…”

Section: Symptomatic Flatfootmentioning

confidence: 99%

Pediatric Pes Planus: A State-of-the-Art Review

2016

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Flatfoot (pes planus) is common in infants and children and often resolves by adolescence. Thus, flatfoot is described as physiologic because it is usually flexible, painless, and of no functional consequence. In rare instances, flatfoot can become painful or rigid, which may be a sign of underlying foot pathology, including arthritis or tarsal coalition. Despite its prevalence, there is no standard definition for pediatric flatfoot. Furthermore, there are no large, prospective studies that compare the natural history of idiopathic, flexible flat feet throughout development in response to various treatments. The available literature does not elucidate which patients are at risk for developing pain and disability as young adults. Current evidence suggests that it is safe and appropriate to simply observe an asymptomatic child with flat feet. Painful flexible flatfoot may benefit from orthopedic intervention, such as physical therapy, bracing, or even a surgical procedure. Orthotics, although generally unproven to alter the course of flexible flatfoot, may provide relief of pain when present. Surgical procedures include Achilles tendon lengthening, bone-cutting procedures that rearrange the alignment of the foot (osteotomies), fusion of joints (arthrodesis), or insertion of a silicone or metal cap into the sinus tarsi to establish a medial foot arch (arthroereisis). It is important for a general pediatrician to know when a referral to an orthopedic specialist is indicated and which treatments may be offered to the patient. Updated awareness of the current evidence regarding pediatric flatfoot helps the provider confidently and appropriately counsel patients and families.

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“…The systematic search in the electronic databases resulted in 341 articles. After applying the eligibility criteria, eight studies were selected [13][14][15][16][17][18][19][20] ( Figure 1 years. Only three authors performed prospective studies 14,16,19 .…”

Section: Resultsmentioning

confidence: 99%

Osteotomia de alongamento da coluna lateral do calcâneo para tratamento do pé plano flexível sintomático de crianças e adolescentes: revisão sistemática.

Lima

Volpon

2018

Rev. Col. Bras. Cir.

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RESUMO O pé plano flexível é condição frequente na criança pequena e apresenta forte tendência para correção espontânea, ou tornar-se moderado ou leve no adulto, o que não causará problemas futuros. Entretanto, em uma pequena proporção de casos a deformidade é mais grave, não melhora, o que pode levar ao comprometimento do desempenho mecânico, deformidade e, eventualmente, dor. Nestes casos o tratamento cirúrgico deve ser considerado. O objetivo desta revisão sistemática foi avaliar os resultados da literatura no tratamento do pé plano flexível sintomático da criança ou adolescente por um procedimento bastante frequente que é a osteotomia de alongamento da coluna lateral do calcâneo. Foi realizada busca sistemática eletrônica nas bases de dados PubMed, Web of Science, Cochrane, CINAHL, SciELO, SCOPUS e LILACS por artigos publicados entre março de 1975 e setembro de 2016. Após aplicação dos critérios de elegibilidade, os artigos selecionados foram avaliados quanto aos resultados clínicos, radiográficos e complicações. Dos 341 artigos encontrados nas bases de dados, apenas oito estudos foram selecionados, segundo os critérios de inclusão e exclusão, com um total de 105 pacientes e 167 pés tratados. Somente três autores realizaram estudo prospectivo, mas sem caso controle ou aleatorização. A maioria das publicações no período avaliado é composta por estudos descritivos ou série de casos (nível de evidência III ou IV), com grandes variações metodológicas, mas com alto índice de satisfação dos pacientes e cirurgiões, em relação aos resultados. Entretanto, são necessárias pesquisas com desenho prospectivo, aleatorizado, grupo controle adequado e critérios de avaliação validados.

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Comparison of the Calcaneo-Cuboid-Cuneiform Osteotomies and the Calcaneal Lengthening Osteotomy in the Surgical Treatment of Symptomatic Flexible Flatfoot

Abstract: Level III, retrospective comparative study.

Cited by 62 publications

References 25 publications

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Pediatric Pes Planus: A State-of-the-Art Review

Osteotomia de alongamento da coluna lateral do calcâneo para tratamento do pé plano flexível sintomático de crianças e adolescentes: revisão sistemática.

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