Surgical Treatment of Flexible Flatfoot in Children

Giannini, Benedetta; Ceccarelli, Francesco; Benedetti, M.G.; Catani, Fabio; Faldini, Cesare

doi:10.2106/00004623-200100022-00003

Cited by 120 publications

(111 citation statements)

References 2 publications

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“…Reports have described the use of various materials for subtalar joint arthroereisis including a bone plug, silicone, poly-L-lactic acid and ultra-high weight polyethylene. This procedure has been popularized in the podiatric community [1][2][3]6].…”

Section: Discussionmentioning

confidence: 99%

“…It is believed by some that flexible flatfeet in children, if left untreated, may lead to disabling secondary deformities and foot pain in adolescence or early adulthood, although this has never been substantiated. [1,2] Despite the absence of any convincing evidence that flexible flatfeet actually lead to functional problems or pain, many authors have recommended surgical treatments for children with painless flexible flatfeet. [1,[3][4][5] Among the procedures recommended, subtalar arthroereisis utilizing a high molecular weight polyethylene implant is considered to be a minimally invasive procedure.…”

Section: Introductionmentioning

confidence: 99%

“…[1,2] Despite the absence of any convincing evidence that flexible flatfeet actually lead to functional problems or pain, many authors have recommended surgical treatments for children with painless flexible flatfeet. [1,[3][4][5] Among the procedures recommended, subtalar arthroereisis utilizing a high molecular weight polyethylene implant is considered to be a minimally invasive procedure. The reported advantages of this technique over other surgical methods are that it can be done through a small incision with little postoperative immobilization and a rapid recovery.…”

Section: Introductionmentioning

confidence: 99%

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Extensive Implant Reaction in Failed Subtalar Joint Arthroereisis: Report of Two Cases

Scher

Bansal

Handler-Matasar

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Foreign body synovitis with extensive granulomatous giant cell reaction to refractile polyethelene debris is a complication of subtalar arthroereisis not previously reported. We present two cases whereby STApeg implants were used to treat bilateral painful flexible flatfoot deformities in children. Two boys, presented at 7 and 10 years of age, 2 years after STA-peg procedures and tendo-Achilles lengthening for painful flatfeet. They each had minimal subtalar motion and pain at the sinus tarsi. Radiographs demonstrated surgical defects in the calcaneus with surrounding high signal on the magnetic resonance imaging (MRI) in the subchondral bone of the calcaneus and talus. Both patients failed conservative management and had their implants removed with good relief of their pain. Histology was submitted at the time of implant removal. We present the radiographic and pathologic findings seen in these two patients with failed subtalar arthroereisis due to extensive implant reaction. The pathologic process seen in these patients is a previously unreported complication of this procedure. We do not recommend arthroereisis in the treatment of painful flexible flatfoot in children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Extensive Implant Reaction in Failed Subtalar Joint Arthroereisis: Report of Two Cases

Scher

Bansal

Handler-Matasar

et al. 2007

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

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“…Arthroereisis by means of synthetic implants was started in the late 1970s because of the reported problems and complications associated with the bony arthroereisis procedures. No less than ten types of synthetic implants and methods for insertion have been reported, most with follow-up of less than 2 years [85][86][87][88][89][90][91][92][93][94][95][96][97].…”

Section: Treatmentmentioning

confidence: 99%

“…According to published descriptions, both are inserted into the sinus tarsi anterior to the posterior facet along the trajectory of the tarsal canal between the posterior and middle facets. The originators of these implants [85,86,90,91], as well as other authors [87,[92][93][94][95]97], and even the product technique manuals, are evasive regarding the depth to which the implants enter the tarsal canal, though they certainly appear to enter it. Nevertheless, proponents consider them to be extra-articular, if inserted properly, because they do not technically touch articular cartilage, though they clearly encroach upon it.…”

Section: Treatmentmentioning

confidence: 99%

Flexible flatfoot in children and adolescents

Mosca

2010

Journal of Children's Orthopaedics

268

229

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Flexible flatfoot is a normal foot shape that is present in most infants and many adults. The arch elevates spontaneously in most children during the first decade of life. There is no evidence that a longitudinal arch can be created in a child's foot by any external forces or devices. Flexible flatfoot with a short Achilles tendon, in contrast to simple flexible flatfoot, is known to cause pain and disability in some adolescents and adults. Joint-preserving, deformity-correcting surgery is indicated in flexible flatfeet with short Achilles tendons when conservative measurements fail to relieve pain under the head of the plantar flexed talus or in the sinus tarsi area. Osteotomy is the fundamental and central procedure of choice. In almost all cases, Achilles tendon lengthening is required. In some cases, rigid supination deformity of the forefoot is present, requiring identification and concurrent treatment.

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Technical note: A volumetric method for measuring the longitudinal arch of human tracks and feet

Hatala,

Gatesy,

Manafzadeh

et al. 2024

American Journal of Biological Anthropology

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Fossil footprints (i.e., tracks) were believed to document arch anatomical evolution, although our recent work has shown that track arches record foot kinematics instead. Analyses of track arches can thereby inform the evolution of human locomotion, although quantifying this 3‐D aspect of track morphology is difficult. Here, we present a volumetric method for measuring the arches of 3‐D models of human tracks and feet, using both Autodesk Maya and Blender software. The method involves generation of a 3‐D object that represents the space beneath the longitudinal arch, and measurement of that arch object's geometry and spatial orientation. We provide relevant tools and guidance for users to apply this technique to their own data. We present three case studies to demonstrate potential applications. These include, (1) measuring the arches of static and dynamic human feet, (2) comparing the arches of human tracks with the arches of the feet that made them, and (3) direct comparisons of human track and foot arch morphology throughout simulated track formation. The volumetric measurement tool proved robust for measuring 3‐D models of human tracks and feet, in static and dynamic contexts. This tool enables researchers to quantitatively compare arches of fossil hominin tracks, in order to derive biomechanical interpretations from them, and/or offers a different approach for quantifying foot morphology in living humans.

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Surgical Treatment of Flexible Flatfoot in Children

Cited by 120 publications

References 2 publications

Extensive Implant Reaction in Failed Subtalar Joint Arthroereisis: Report of Two Cases

Extensive Implant Reaction in Failed Subtalar Joint Arthroereisis: Report of Two Cases

Flexible flatfoot in children and adolescents

Technical note: A volumetric method for measuring the longitudinal arch of human tracks and feet

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