Calcaneo-stop procedure for paediatric flexible flatfoot
- Péter KellermannAffiliated withDepartment of Orthopaedics, Szent-Györgyi Albert Clinical Centre, University of Szeged Email author
- , Sandor RothAffiliated withClinical Hospital Center
- , Katalin GionAffiliated withDepartment of Radiology, Szent-Györgyi Albert Clinical Centre, University of Szeged
- , Krisztina BodaAffiliated withDepartment of Medical Informatics, Szent-Györgyi Albert Clinical Centre, University of Szeged
- , Kálmán TóthAffiliated withDepartment of Orthopaedics, Szent-Györgyi Albert Clinical Centre, University of Szeged
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Flexible flatfoot is a frequent deformity found in children. The aim of this study is to evaluate the pedographic outcome of the percutaneous arthroereisis with the use of a screw through the sinus tarsi into the talus.
Materials and methods
43 calcaneo-stop procedures of 25 patients (18 bilateral, seven unilateral) were evaluated. Mean age at surgery was 10 years (7–14, SD 2.2) (SD: standard deviation), mean follow-up time was 9.7 months (3–19, SD 5.5). Patient satisfaction rate was recorded, the Meary’s talus-first metatarsal angle was measured with lateral radiograms, and a dynamic pedographic assessment was also performed.
Patient satisfaction rate was excellent for 33 feet of 19 children, good for eight feet of five children, and poor for either feet of one child. We did not observe any complications during or following the surgery.The mean rest heel valgus decreased from 13.4° (10°–17°, SD 1.5) to 2.8° (0°–6°, SD 1.7) post op. The Meary’s angle improved from 160.2° (148°–177°, SD 6.8) to 175.9° (167°–179°, SD 3.5). By pedographic analysis, the area and the pressure–time integral (load amount, PTI) values increased on the lateral regions of the sole (except for the lesser toes) and decreased on the medial areas (except for the hallux). The relative contact time in the lateral midfoot increased from 63.8% (39.6–78.4%, SD 10.6) to 75.1% (50–86.1%, SD 9.4), and that in the lateral forefoot region from 81.2% (60.4–89.2%, SD 6.6) to 86.8% (78.1–97.1%, SD 4.8).
The calcaneo-stop procedure is a simple and reliable method for the correction of severe flexible paediatric flatfoot. Our prospective, short-term results following the anterograde screw implantation into the talus correlate well with the results of similar or different arthroereisis methods. Further investigations are required to evaluate the long-term outcome of the screw calcaneo-stop method, including the conditions following implant removal.
KeywordsPes planovalgus Flatfoot Arthroereisis Calcaneo-stop
- Calcaneo-stop procedure for paediatric flexible flatfoot
Archives of Orthopaedic and Trauma Surgery
Volume 131, Issue 10 , pp 1363-1367
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- 1. Department of Orthopaedics, Szent-Györgyi Albert Clinical Centre, University of Szeged, Szeged, 6. Semmelweis str, 6725, Hungary
- 2. Clinical Hospital Center, Rijeka, Croatia
- 3. Department of Radiology, Szent-Györgyi Albert Clinical Centre, University of Szeged, Szeged, Hungary
- 4. Department of Medical Informatics, Szent-Györgyi Albert Clinical Centre, University of Szeged, Szeged, Hungary