Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review

Park, Jung Ho; Lee, Soon Hyuck; Kim, Soo Hyun; Jang, Woo Young; Baek, Jung Heum; Sung, Hyun Jae; Choi, Gi Won

doi:10.1007/s00264-019-04303-3

Cited by 33 publications

(24 citation statements)

References 53 publications

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, a high percentage of satisfaction (78.5% vs 96.4%)[ 34 ] with AR procedures, lower risk and complication rates were reported when compared with other procedures. Suh et al [ 34 ] reported complication rates of 3.5% to 45% of minor complications in more than 50% of LCL studies. They also reported a 30% rate difference in complications between silicone, polyethylene, staple, titanium, bioresorbable, and stainless steel “old-type” AR implants (45%) and “recent-type” implants (15.4%).…”

Section: Discussionmentioning

confidence: 99%

“…Baryeh et al [ 36 ] reported partially conclusive data supporting the subtalar AR as an adjunct treatment, but the analysis was limited to adult acquired flatfoot. Suh et al [ 34 ] performed a comparison between AR and the LCL procedures and concluded that LCL achieved more radiographic corrections and more improvements in the AOFAS score than the AR. Complications were more common in the LCL group than in the AR group, and the reoperation rates in the two groups were similar.…”

Section: Discussionmentioning

confidence: 99%

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Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

Vescio

Testa

Amico

et al. 2021

WJO

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BACKGROUND Flexible flatfoot (FFF) is a very common condition in children, characterized by the loss of the medial arch and by an increase in the support base with valgus of the hindfoot. Arthroereisis (AR) procedures are widely performed corrective surgeries and are classified as subtalar AR and calcaneo-stop (CS). AIM We investigated the literature published in the last 5 years with the aim of providing an update on the evidence related to AR treatment in FFF patients. We report the principal findings of subtalar AR and CS procedures concerning clinical and radiological outcomes and complication rates in the general population, young athletes, and obese people according to material device. METHODS Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review of studies published in the past 5 years and included the PubMed and Science Direct databases was performed on May 6, 2020. The research string used was (pediatric OR children OR Juvenile NOT adult) AND (flexible NOT rigid) AND (flat foot OR pes planus) AND (calcaneo-Stop OR arthroereisis OR subtalar extra-articular screw OR SESA OR subtalar arthroereisis OR endosinotarsal). The risk of bias assessment was performed using the Dutch checklist form for prognosis. RESULTS A total of 47 articles were found. Ultimately, after reading the full text and checking reference lists, we selected 17 articles that met the inclusion and exclusion criteria. A total of 1864 FFFs were identified. Eight studies concerned the subtalar AR (47.1%) and nine concerning CS (52.9%). The average age of patients at start of treatment was 11.8 years, the average follow-up of the studies was 71.9 mo (range 29.1-130). Globally, complications occurred in 153 of the 1864 FFF treated, with a rate of 8.2%. CONCLUSION Both AR procedures are valid surgical techniques for treating FFF. Surgeon experience, implant cost, and cosmetic correction are the most common considerations included in the orthopedic device decision-making process. In obese patients, the subtalar AR is not recommended. In adolescents who need to improve sports performance, the CS screw had better results compared with other implants.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

Vescio

Testa

Amico

et al. 2021

WJO

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“…The subtalar arthroereisis is a minimally invasive procedure that provides good mid-term outcomes but material migration and pain can occur and AOFAS-AH scores and radiographic corrections are less improved than in calcaneal lengthening. 27 , 28 The horseman procedure shares the same principles as the subtalar arthroereisis techniques. Temporary blocking the calcaneopedal unit by a screw allows satisfying immediate and long-lasting correction.…”

Section: Discussionmentioning

confidence: 99%

Medium-term results of calcaneus lengthening in idiopathic symptomatic flat foot in children and adolescents

Khouri

Delpont

2020

Journal of Children's Orthopaedics

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Purpose Calcaneus lengthening can be used in symptomatic flat foot in children, but few details on its medium-term results and complementary procedures are available. Methods A total of 20 flexible, symptomatic, idiopathic valgus flat feet (in 15 children; mean age 13.9 years (10 to 17)) were operated on. Complementary procedures were based on preoperative and intraoperative analyses. Radiographic measurements were obtained preoperatively and with at least four years follow-up. Results At a mean of 8.3 years (4 to 15) postoperatively, 13 feet had good clinical and radiological results, with significant improvement in American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scale scores and radiological measurements. Seven feet had residual pain. Six of them had no osteotomy of the first cuneiform. Conclusion Calcaneus lengthening with adequate complementary musculo-tendinous and/or bone procedures according to preoperative and intraoperative foot deformation leads to good medium-term results. Forefoot supination is the most frequent residual defect. If present intraoperatively, first cuneiform pronation-flexion osteotomy is indicated. Level of evidence IV

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“…Thus, it is critical to expose the sural nerve under direct visualization and protect it carefully during operation. The most common complication of LCL was calcaneocuboid subluxation and increased risk of calcaneocuboid arthritis [15], which did not occur in our patients. The patients with an average age of 11.7 years had a strong growth potential to remodel the soft tissue balance.…”

Section: Resultsmentioning

confidence: 44%

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

Wen

Nie

Cheng

et al. 2020

Preprint

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Background: The indications for surgery, timing, and procedure in children with flexible flatfoot deformity remain controversial. For marked deformities, combined procedures are preferred to correct multiple plane deformities. Thus, this study aimed to evaluate the outcomes of osteotomies combined with soft tissue procedures in children with flexible flatfoot aged 9-14 years.Methods: From July 2014 to October 2017, 28 children (47 feet) with flexible flatfoot with an average age of 11.7±2.1 (range 9-14) years underwent osteotomy combined with soft tissue surgery. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Foot and Ankle Outcome Score (FAOS) were used to evaluate the preoperative and postoperative clinical outcomes. The talo-navicular coverage angle (TNCA) and talar–first metatarsal angle (T1MA) on the foot anteroposterior view, calcaneal pitch angle and Meary’s angle on the foot lateral view, and calcaneus valgus angle (CVA) on the Saltzman view were also observed.Results: All patients were followed up for an average duration of 29.7±8.6 months. Mean AOFAS and FAOS significantly improved from 56.6±8.0 and 47.4±9.5 preoperatively to 88.4±3.9 and 83.2±6.8 at final follow-up (P<0.001). respectively. There were statistically significant differences between preoperative and postoperative scores in all FAOS subscales (P<0.001). Radiographic parameters, such as TNCA (P<0.001) and T1MT (P<0.001) on foot AP views, calcaneal pitch angle (P=0.014) and Meary,s angle (P<0.001) on foot lateral views, and CVA (P<0.001) on Saltzman views, were significantly improved. All patients and their parents were satisfied with the functional outcomes.Conclusion: Osteotomies combined with soft tissue procedures are an effective strategy for flexible flatfoot deformity in children, as it results in favorable radiographic and functional outcomes.

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Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review

Cited by 33 publications

References 53 publications

Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

Medium-term results of calcaneus lengthening in idiopathic symptomatic flat foot in children and adolescents

Osteotomies combined with soft tissue procedures for symptomatic flexible flatfoot deformity in children

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