Radiographic and Functional Results following SubtalarArthroereisis in Pediatric Flexible Flatfoot

Flexible flatfoot (FFF) is one of the most common skeletal disorders in children. In symptomatic patients who do notrespond to conservative measures, surgery may be an option. Subtalar arthroereisis consists of limiting excessive eversion of thesubtalar joint through different types of implants.Materials and Methods. Wecarried out a retrospective study of 16 patients (32 feet)intervened for FFF with a subtalar device (arthroereisis), across the period of 2008-2015 with a minimum follow-up period of oneyear. Pre- and postoperative measures of the Moreau-Costa-Bartani angle, dorsoplantar (DP) and lateral (L) talocalcaneal angle,talonavicular coverage angle, and naviculocuboid overlap were used to evaluate correction of the deformity. Two expert surgeonsfrom the Pediatric Orthopedics Unit took separate measurements of these angles for subsequent analysis purposes and to obtainthe interobserver correlation coefficient for quantitative variables. Pre- and postoperative differences in the measurement of angleswere ascertained using Student’st-test for paired samples; and a functional evaluation of the patients intervened was carried outpre- and postoperatively by administering the parent version of the Oxford Ankle Foot Questionnaire for Children (OxAFQ-C)during a clinical interview. All statistical analyses were performed using the SPSS v. 19.0 program (SPSS, Chicago, IL), with valuesbeing deemed statistically significant atp<0.05.Results. A breakdown of the study population showed 81.25% (13 patients) malesand 18.75% (3 patients) females, with mean age of 9 years (7-11). The interobserver coefficient for quantitative variables displayeda very high degree of concordance (0.7-0.9), indicating that the validity of the measures was adequate. Pre- and postoperativeanalysis of differences in the measurement of angles was statistically significant (p<0.005). In terms of functional evaluation, thepostoperative results were positive, with statistical significance for the “school and play”, “emotional”, and “footwear” domainsof the OxAFQ-C scale and no differences in the “physical” domain.Conclusion. Subtalar arthroereisis is a valid option for thetreatment of symptomatic pediatric flatfoot, with good postoperative functional and radiographic results