Pedobarographic changes during first month after subtalar extra-articular screw arthroereisis (SESA) operation of juvenile flexible flatfoot

Hagen, Lasse; Pape, Jonas Paul; Kostakev, Mark; Peterlein, Christian‐Dominik

doi:10.1007/s00402-019-03230-7

Cited by 25 publications

(37 citation statements)

References 30 publications

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“…This study provides new insights in diagnostical approaches by using pedobarography which helps to dynamically assess foot alignment. In addition to clinical examination pedobarography improves the three-dimensional understanding of FFF and its treatment [ 3 , 4 , 5 ]. Comparable studies to discuss the observation in the context of actual literature are rare.…”

Section: Discussionmentioning

confidence: 99%

“…For data analysis the database Medical Professional (Version 12.2.7, Novel GmbH, Munich, Germany) was used. Selected pedobarographic parameters such as the arch index [ 23 ], the medial midfoot contact area and the medial forefoot peak pressure [ 4 , 5 ] were assessed preoperatively and at follow-up ( Figure 5 ).…”

Section: Methodsmentioning

confidence: 99%

“…Standard assessment includes clinical and radiological examination. Modern technology such as digital pedobarography has helped to improve understanding and treatment of the deformity [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…For STA self-locking absorbable [ 8 , 14 , 15 ] or non-absorbable [ 16 , 17 , 18 , 19 ] devices implanted in the sinus tarsi acting as a plug as well as impact blocking subtalar extraarticular screw arthroereises (SESA) [ 6 , 12 , 20 ] can be applied. While pedobarography is an established method for the analysis of foot deformity, its role in assessing the outcome of STA performed in patients with FFF remains to be further elucidated [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

et al. 2021

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Subtalar arthroereises (STA) is a minimally invasive and reversible surgery to correct symptomatic flexible flatfoot (FFF) in children. Various techniques were described either applying expandable sinus tarsi implants or lateral calcaneus stop screws. Studies comparing the outcome of STA with different devices are rare. This retrospective single-center cohort study analyzes the results of STA using three different implants. 113 STA were performed in 73 consecutive patients (28 females). Mean age at surgery was 10.8 years (range 5–16). Mean follow-up was 29.0 months (range 1–111). In 21 feet the non-absorbable Kalix® endorthesis and in 56 feet the absorbable Giannini endorthesis were applied. Subtalar extraarticular screw arthroereises (SESA) was conducted in 36 feet. Clinical, radiographic and pedobarographic parameters were analyzed. No intraoperative complications were observed. All three procedures achieved comparable improvements of the clinical, radiographic and pedobarographic parameters. The mean foot function index (FFI) improved from 36.4 (range 12–63) to 22.8 (range 2–55). The mean preoperative calcaneal inclination angle and the lateral talocalcaneal angle improved from 9.5° (range 0–22) and 42.3° (range 21–62) to 12.8° (range 0–26) and 37.6° (range 15–56), respectively. Pedobarographically determined values of the arch index, the medial midfoot contact area and the medial forefoot peak pressure decreased. In contrast to SESA (1/36, 3%), a higher incidence of implant-related complications was observed using Kalix® (6/21, 29%) and Giannini (10/56, 8%) sinus tarsi implants. Peroneal muscle contractures only occurred in the SESA group (4/36, 11%). Premature removal due to treatment-related complications was necessary in 6/21 Kalix® implants (29%), 4/56 Giannini implants (7%) and 4/36 SESA implants (11%). Implant choice for treatment of painful FFF in children with STA seems to play a subordinate role. Clinical, radiographic and pedobarographic outcomes are comparable between the applied implants. Surgeons and patients should be aware of the different spectrum of implant-related complications. Treatment can be reliably monitored by radiation-free pedobarography providing dynamic information about the deformity.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

et al. 2021

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“…However, the necessity of implant removal is still a negative aspect of the procedure, and most current studies focus on overcoming this problem by developing new bio-absorbable implants and evaluating their effects on correction [6,8,9]. There are few comparative studies investigating the biomechanical effects of this procedure on foot plantar pressures [10,11].…”

Section: Introductionmentioning

confidence: 99%

Arthroereisis of the subtalar joint in the management of pediatric flexible flatfoot: A retrospective clinical study

Neyisci¹,

Erdem²

2021

Journal of Surgery and Medicine

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Background/Aim: Management of flatfoot is still a challenge for orthopedic surgeons because it is a common and physiological process that usually requires observation and follow-up due to its asymptomatic nature in the pediatric population. The aim of this study was to investigate the radiological and pedobarographic results of symptomatic flexible flatfoot in pediatric patients who were treated by simultaneous gastrocnemius lengthening and arthroereisis of the subtalar joint. Methods: This retrospective cohort study included 20 feet of 10 children (5 males, 5 females; mean age: 11.4 years; age range 9-14 years) who underwent simultaneous gastrocnemius lengthening and subtalar joint arthroereisis procedure for bilateral symptomatic flatfoot. The mean follow-up period was 24 months (range 11-32). All arthroereisis procedures were performed using a cannulated arthroereisis titanium implant. To assess the radiological results, calcaneal pitch angle and Meary's talus-first metatarsal angle on radiographs were measured preoperatively and at the final follow-up. Pedobarographic assessment was based on plantar heel and forefoot pressures preoperatively and at the final follow-up. Results: The mean calcaneal pitch angle increased from 8° (0.93°) preoperatively to 16.5° (1.14°) postoperatively (P<0.001), while the mean Meary's talus-first metatarsal angle decreased from 7.5° (1.14°) preoperatively to 0.5° (0.51)° postoperatively (P<0.001). The mean heel peak pressure and forefoot peak pressure increased from 11.5 (1.14) N/cm 2 and 10.5 (1.14) N/cm 2 preoperatively to 17.5 (1.14) N/cm 2 and 15.5 (1.14) N/cm 2 postoperatively, respectively (P<0.001 for both variables). In addition, the pedobarographic assessment revealed that medially increased center of pressure moved to laterally increased center of pressure in all feet with an improvement in terms of forefoot and heel pressures. None of the patients experienced major intraoperative or postoperative complications. Conclusion: Simultaneous gastrocnemius lengthening and arthroereisis of the subtalar joint seems an effective and safe surgical option for symptomatic flexible flatfoot in pediatric patients.

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Pedobarography in Physiotherapy: A Narrative Review on Current Knowledge

Lorkowski

Gawrońska

2021

Advances in Experimental Medicine and Biology

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Pedobarographic changes during first month after subtalar extra-articular screw arthroereisis (SESA) operation of juvenile flexible flatfoot

Cited by 25 publications

References 30 publications

Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

Arthroereisis of the subtalar joint in the management of pediatric flexible flatfoot: A retrospective clinical study

Pedobarography in Physiotherapy: A Narrative Review on Current Knowledge

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