KMID : 0361620170520060543
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Journal of the Korean Orthopaedic Association 2017 Volume.52 No. 6 p.543 ~ p.551
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Subtalar Arthroereisis Using Kalix¢ç Sinus Tarsi Implant for Pediatric Flexible Flatfoot
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Hwang Seok-Min
Eom Joon-Sang Lee Dong-Oh Lee Jong-Soo Kim Sung-Wook Won Tae-Gu Jung Hong-Geun
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Abstract
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Purpose: The purpose of this study was to evaluate the radiographic and clinical outcomes of subtalar arthroereisis as a method of treatment for pediatric flexible flatfoot.
Materials and Methods: We retrospectively investigated 14 feet among 10 patients with flexible flatfoot, who were treated with a subtalar arthroereisis using a sinus tarsi implant between March 2007 and June 2012. Radiographically, the talo-1st metatarsal angle, talar declination, and calcaneal pitch angle have all been measured on lateral radiographs. The talo-navicular coverage angle and talo-1st metatarsal angle was measured on anteroposterior (AP) radiographs and tibio-calcaneal angle was assessed by hindfoot alignment view. Visual analogue scale (VAS) pain scores and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were used for clinical evaluation.
Results: The mean follow-up was 48.7 months (16?98 months), and the mean age was 11.6 years (6?19 years). Radiographically, the mean pre-operative and postoperative values measured by the lateral foot radiograph were ?25.1¡Æ and ?7.5¡Æ for talo-1st metatarsal angle, 37.4¡Æ and 23.2¡Æ for talar declination, and 8.3¡Æ and 15.0¡Æ for calcaneal pitch angle, respectively. The mean preoperative and postoperative values measured by foot AP radiograph were 23.0¡Æ and 11.9¡Æ for talo-navicular coverage angle and 17.2¡Æ and 9.0¡Æ for talo-1st metatarsal angle, respectively. Moreover, tibio-calcaneal angle improved from valgus 17.4¡Æ on average to 4.5¡Æ on average. Clinically, the VAS score and AOFAS score was improved from 5.8 to 1.5 and from 61.8 to 90.4, respectively. Complication was sinus tarsi pain that occurred in 5 cases (35.7%).
Conclusion: We achieved a satisfactory correction of pediatric flexible flatfoot deformities via subtalar arthroereisis, using a sinus tarsi implant with favorable radiographic and clinical measures. However, high potential complication rate of postoperative sinus tarsi pain on weight-bearing should carefully be considered.
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KEYWORD
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flatfoot, subtalar arthroereisis, sinus tarsi implant, sinus tarsi pain
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