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.