Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity
Effectiveness of subtalar arthroereisis with endorthesis for pediatric flexible flat foot: a retrospective cross-sectional study with final follow up at skeletal maturity
复制标题
DOI：
10.1016/j.fas.2018.12.002
复制
发表时间：
2020-01-01
影响因子：
2.5
通讯作者：
Usuelli, Federico Giuseppe
中科院分区：
文献类型：
--
作者：
Indino, Cristian;Villafane, Jorge Hugo;Usuelli, Federico Giuseppe
背景：儿童柔性扁平足有时没有症状，但很少会导致身体损伤、疼痛和行走困难。我们评价了在距下关节置换术的介入治疗儿童柔性扁平足的放射学效果，并在骨骼成熟时进行了最后的随访。56例(112足)接受距下关节置换治疗的儿童屈曲扁平足(平均随访年龄15.5±1.2岁，女性39.3%)纳入研究对象。所有的放射学检查都在医院进行。测量跟骨外侧角(Cp)、跟骨距骨角(MA)、距舟前后角(APTN)、距舟外翻百分率(TnU)。最短随访时间为18个月。在手术前和最后一次随访时对这些措施进行评估。结果：在最后一次随访时，接受距下关节置换治疗的儿童灵活扁平足的所有放射学测量参数均有统计学意义的改善(ALL，p<；0.004)。平均随访时间为40.1+/-23.6个月。临床参数与随访期的足部X线片参数无相关性。结论：我们的结果表明，儿童柔性扁平足内固定术能有效改善骨骼成熟期的X线片参数。在骨骼生长结束时的形态矫正量应该主要是为了预测外侧距跟骨线和距舟骨的一致性(MA，APTN，TNU)。(C)2018欧洲足踝协会。爱思唯尔有限公司出版。保留所有权利。
Background: Pediatric flexible flatfoot is sometimes asymptomatic but it can rarely cause physical impairment, pain, and difficulty walking. We evaluated the radiographic effectiveness of intervention of subtalar arthroereisis with endorthesis for pediatric flexible flatfoot with final follow-up at skeletal maturity.Methods: This is a retrospective cross-sectional study. 56 consecutive patients (112 feet) who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot (mean age at final follow-up 15.5 +/- 1.2 years, 39.3% female) were enrolled. All the radiographic studies were performed in the hospital. Radiographs (standard weight-bearing radiographs of the foot with anteroposterior and lateral view) were used to measure lateral talocalcaneal angle (LTC), calcaneal pitch angle (CP), Meary's angle (MA), anteroposterior talonavicular angle (APTN), talonavicular uncoverage percent (TNU). Minimum follow-up was 18 months. Measures were assessed pre-operatively and at the final follow-up. Clinical and functional parameters were assessed at the final follow-up.Results: Children who underwent surgical treatment with subtalar arthroereisis for pediatric flexible flatfoot exhibited a statistically significant improvement in all radiographic measurement parameters at the last follow-up at skeletal maturity (all, p < 0.004). Mean follow-up was 40.1 +/- 23.6 months. Clinical parameters were not correlated with the foot radiographic parameters at follow up period.Conclusions: Our results suggest that endorthesis in pediatric flexible flatfoot was effective for improving radiographic parameters at skeletal maturity. The amount of the morphologic correction at the end of the skeletal growth should be expected mainly for lateral tarso-metatarsal alignment and talo-navicular congruency (MA, APTN, TNU). (c) 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.