Dear Editor.
We recently read an article by [1] entitled Joint preservation surgery for correcting adolescents’ spasmodic flatfoot deformity. Early results from a specialized North African foot and ankle unit. The authors’ contribution is highly recognized and appreciated. The authors conducted a prospective case study of 24 patients (27 feet) with idiopathic spasmodic flatfoot deformity (SFFD) who had failed conservative treatment, and this study found that careful clinical and radiological evaluation for correctly detecting the possible cause of SFFD is paramount for successful management. It is worthwhile to recognize that joint-preserving osteotomy combined with elective soft tissue surgery can contribute to further postoperative functional recovery in young patients with good imaging results. However, there are still some issues that need to be discussed.
First, during surgical treatment, different implants, implant shapes, and types may have an impact on the results of the study [2] retrospectively analyzed the surgical approach and prognosis of 31 patients with flat feet and found that the type of implant material and different shapes may change the results of the experiments in prospective studies. Secondly, in this study, the authors did not consider the difference in prognosis between patients with unilateral flat feet and those with bilateral flat feet [3] retrospectively analyzed the prognosis of 13 patients with flat feet, and the study found that placing patients suffering from unilateral and those suffering from bilateral in the same group may have an impact on the final outcome.
Meanwhile, in this article, the authors wanted to further investigate the early outcomes of joint preservation surgery for adolescents with spastic flatfoot deformity (SFFD), but there are still some shortcomings overall. As the authors mentioned in the article, this study lacked a control group, which would have compromised the accuracy of the experimental results. In addition, the study did not assess patient satisfaction, pain, function, or quality of life outcomes. In the study by, [4] the abovementioned factors can affect the accuracy of the study results. Therefore, the authors should consider the interference of these factors on the study results, which in turn will make the experimental data more accurate. Finally, we thank the authors again for their contribution, and this study provides a new theoretical basis for the treatment of SFFD.
References
Fadle AA, Khalifa AA, Bahy A, El-Gammal YT, Abubeih H, El-Adly W, Osman AE (2023) Joint preservation surgery for correcting adolescents’ spasmodic flatfoot deformity: early results from a specialized North African foot and ankle unit. Int Orthop. https://doi.org/10.1007/s00264-023-06011-5
Wang S, Chen L, Yu J, Zhang C, Huang JZ, Wang X, Ma X (2020) Mid-term results of subtalar arthroereisis with Talar-Fit implant in pediatric flexible flatfoot and identifying the effects of adjunctive procedures and risk factors for sinus tarsi pain. Orthop Surg 13(1):175–184. https://doi.org/10.1111/os.12864
Kim JR, Park CI, Moon YJ, Wang SI, Kwon KS (2014) Concomitant calcaneo-cuboid-cuneiform osteotomies and the modified Kidner procedure for severe flatfoot associated with symptomatic accessory navicular in children and adolescents. J Orthop Surg Res 9:131. https://doi.org/10.1186/s13018-014-0131-2
Iosue H, Albright J, Sanders E, Morra A, Kidon A, Mendeszoon M (2022) Opening cuboid wedge osteotomy (zoom osteotomy) for triplanar correction of flexible pes planovalgus deformities. J Foot Ankle Surg 61(5):1023–1027. https://doi.org/10.1053/j.jfas.2022.01.007
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Zhao, Z., Zhang, B., Rong, C. et al. Letter to the Editor regarding the article: “Joint preservation surgery for correcting adolescents’ spasmodic flatfoot deformity: early results from a specialized North African foot and ankle unit”. International Orthopaedics (SICOT) 48, 315 (2024). https://doi.org/10.1007/s00264-023-06035-x
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DOI: https://doi.org/10.1007/s00264-023-06035-x