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Forefoot morphology change following subtalar arthroereisis for symptomatic flexible flatfoot in children
Kuang-Yu Cheng1, Chui-Jia Farn2, Chia-Che Lee2
1College of Medicine, National Taiwan University, Taipei City, Taiwan.
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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