[Results evaluation of children flexible flatfoot operative treatment according to Mittelmeier method]

The aim of the study is to evaluate results of the operative treatment of children flexible flatfoot. The investigative material consisted of 16 children (7 girls, 9 boys) treated between 1995-2004. The age at the time of operation was 9-15 years (mean 11.5 year). The average follow up period was 4.5 year (from 1 to 10 years). Clinical examination consisted of physical and subjective examination performed before and after operation. Subjective examination was performed on the basis of questinnaire. Physical examination was completed with hindfoot valgus angle measurement and with podoscopy (Clark's angle and Godunow-Sztriter index measurement). We decided to do surgery in children when conservative treatment failed. Operation was performed according to Mittelmeier method. After surgery we applied short leg cast with 10 degrees foot supination for 4 weeks. We allowed patients to walk without weight bearing by using elbow crutches for 8 weeks, and recommended rehabilitation 2-6 weeks after cast removing. According to static foot parameter we obtained 4 very good, 8 good and 4 sufficient results. According to patients subjective evaluation we obtained 5 very good, 8 good and 3 sufficient results. In two cases we had postoperative complications (prolonged wound healing). On the basis of presented material we can state that surgery according to Mittelmeier method at children above 9 years old could be benefit and should be take into consideration in treatment flexible flatfoot.