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[THE EFFECTIVENESS OF TREATMENT IN CHILDREN WITH RIGID FLATFEET AND DYSFUNCTION OF THE POSTERIOR TIBIAL TENDON]
O Danilov1, A Shulga1, V Gorelik1
1P.L Shupyk National Healthcare University of Ukraine, Pediatric Surgery Department Kyiv, Ukraine.
Georgian Medical News
|December 13, 2021
Summary
Rigid flatfeet in children often stem from posterior tibial tendon dysfunction. Conservative treatment works for mild cases without dysfunction, while subtalar arthroereisis is effective for moderate flatfeet with early tendon issues.
Area of Science:
- Pediatric Orthopedics
- Foot and Ankle Surgery
- Biomechanical Engineering
Background:
- Rigid flatfeet are common pediatric foot deformities.
- Posterior tibial tendon dysfunction (PTTD) can cause rigid flatfeet, pain, and degenerative changes.
- Current surgical indications for PTTD-related rigid flatfeet are not well-defined.
Purpose of the Study:
- To analyze clinical and radiological outcomes of treating rigid flatfeet with PTTD.
- To develop a treatment algorithm based on PTTD stage.
- To evaluate conservative and surgical interventions for pediatric rigid flatfeet.
Main Methods:
- Retrospective analysis of 20 pediatric patients (40 feet) over 12 months.
- Clinical and radiological assessments were performed.
- Patients were stratified by rigid flatfeet severity and PTTD stage (Johnson and Strom classification).
Main Results:
- 90% of patients showed degenerative-dystrophic changes in the posterior tibial tendon.
- Conservative treatment yielded positive results in mild (Grade I) rigid flatfeet without PTTD.
- Subtalar arthroereisis was effective for moderate (Grade II) rigid flatfeet with Stage I PTTD.
Conclusions:
- Conservative treatment is effective for rigid flatfeet without PTTD.
- Subtalar arthroereisis is recommended for Stage I PTTD in pediatric rigid flatfeet.
- A staged treatment approach based on PTTD severity is crucial for optimal outcomes.
