Forefoot morphology change following subtalar arthroereisis for symptomatic flexible flatfoot in children

IF 2 3区医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2025-08-01 DOI:10.1016/j.fas.2025.02.007

Kuang-Yu Cheng , Chui-Jia Farn , Chia-Che Lee , Kevin Chun-Kai Chiu , Kuan-Wen Wu , Ken N. Kuo , Ting-Ming Wang

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Abstract

Background

When symptomatic pediatric flexible flatfoot treated with subtalar arthroereisis to improve hindfoot alignment, the postoperative forefoot supinatus can be a concern.

Methods

We retrospectively reviewed 110 patients (220 feet), ages 5–12, who underwent subtalar arthroereisis from January 2017 to December 2019, with at least two years of follow-up. Of these, 22 patients (44 feet) developed forefoot supinatus with metatarsus primus elevatus (MPE). Radiographic evaluations assessed postoperative forefoot supinatus, calcaneus and talus height. Functional outcomes were measured using the modified American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score.

Results

Improvements in forefoot supinatus were seen over time, with self-correction typically occurring around 6–7 months post-surgery. Bone growth positively influenced symptom relief, while demographic factors had minimal impact. The modified AOFAS score also improved.

Conclusion

Forefoot supinatus and MPE following subtalar arthroereisis tend to self-correct over several months, aligning with pediatric foot bone growth.

Level of evidence

III

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有症状的儿童屈曲扁平足的距下关节挛缩后前足形态改变。

背景：当有症状的儿童柔性扁平足用距下关节挛缩术治疗以改善后足对齐时，术后的前足旋后肌是一个值得关注的问题。方法：我们回顾性分析了110例（220英尺），年龄5-12岁，从2017年1月到2019年12月接受距下关节挛缩的患者，随访至少两年。其中22例（44英尺）出现前足旋后肌并跖骨前突（MPE）。影像学评估术后前足旋肌、跟骨和距骨高度。使用改良的美国矫形足踝学会（AOFAS）前足评分测量功能结果。结果：随着时间的推移，前足旋后肌得到了改善，自我矫正通常发生在手术后6-7 个月左右。骨生长对症状缓解有积极影响，而人口因素影响最小。改进后的AOFAS评分也有所提高。结论：距下关节挛缩后的前足旋后肌和MPE在几个月内趋于自我纠正，与儿童足骨生长一致。证据水平：III。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.