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Does arthroscopic resection of a too-long anterior process improve static disorders of the foot in children and adolescents?

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Abstract

Purpose

A too-long anterior process of the calcaneus is a common cause of pain and hind-foot instability. Our goal was to evaluate the early results of arthroscopic resection in terms of static foot disorders in children and adolescents.

Methods

We retrospectively studied 11 ft (10 patients). The inclusion criteria were treatment of TLAP by arthroscopic resection and a minimum follow-up period of six months. Surgery was indicated in cases with persistent symptomatic TLAP resistant to orthopaedic treatment.

Results

The mean age at surgery was 11 (range, 7–15) years. The mean follow-up duration was 15 (range, 8–28) months. Pre-operatively, we diagnosed four flat feet, two cavus feet and five feet with normal footprints, but loss of physiological hind-foot valgus. All patients presented with subtalar joint stiffness. At the last follow-up, four feet with no hind-foot valgus were normal, two were unchanged and the other feet had improved. The mean AOFAS increased from 61.9 (range, 47–73) to 89.1 (range, 71–97; P = 0.009). The mean radiological angles were near normal, exhibiting significant improvements in the lateral talo-metatarsal and Djian-Annonier angles.

Conclusions

Arthroscopic resection of a TLAP is safe. In the short term, the restoration of subtalar mobility reduces pain, and improves instability and static disorders. Longer follow-up of a larger patient series is required.

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Authors and Affiliations

  1. Service de Chirurgie Pédiatrique, Hôpital Lapeyronie, 191 avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France

    Julien Bourlez, Pauline Joly-Monrigal, Fanny Alkar, Alexandre Laborde, Jerôme Cottalorda, Djamel Louahem & Marion Delpont

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  1. Julien Bourlez
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  2. Pauline Joly-Monrigal
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  3. Fanny Alkar
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  4. Alexandre Laborde
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  6. Djamel Louahem
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  7. Marion Delpont
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Corresponding author

Correspondence to Marion Delpont.

Ethics declarations

Each author certifies that his or her institution approved the protocol of this investigation. All procedures were performed in accordance with the ethical standards of the institutional research committee(s) and complied with the dictates of the 1964 Helsinki declaration and later amendments thereto. All patients gave written informed consent.

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No author has any conflict of interest.

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Bourlez, J., Joly-Monrigal, P., Alkar, F. et al. Does arthroscopic resection of a too-long anterior process improve static disorders of the foot in children and adolescents?. International Orthopaedics (SICOT) 42, 1307–1312 (2018). https://doi.org/10.1007/s00264-017-3740-7

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  • DOI: https://doi.org/10.1007/s00264-017-3740-7

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