Calcaneo-Stop: An Effective Surgical Technique to Correct Symptomatic Flexible Flatfoot in Children

Objective  Flexible juvenile valgus flatfoot is a prevalent condition that typically resolves spontaneously but requires surgical treatment if associated with discomfort, pain, and physical limitation. However, certain surgical procedures are associated with higher morbidity, as they involve osteotomies and arthrodesis. In this context, extra-articular talocalcaneal arthroereisis is an option, because it is a cost-effective, low-morbidity, and efficient method of treatment. The aim of the present study is to report the outcomes of the treatment of flexible juvenile valgus flatfoot using the calcaneo-stop technique. Methods  Pre-adolescent patients with severe or symptomatic flexible juvenile valgus flatfoot were surgically treated using the calcaneo-stop technique (talocalcaneal arthroereisis). The outcomes were evaluated clinically and radiographically, assessing Meary angles, talonavicular coverage, talus-metatarsal alignment, Moreau-Costa-Bertani angle, calcaneal pitch, and the percentage of talus head coverage by the navicular. Results  A total of 23 individuals (44 feet) were evaluated and operated on, with ages ranging from 7 to 13 years (mean: 11) and a mean follow-up of 28 months. There was marked improvement or disappearance of symptoms in 90% of the patients. The complication rate was of 13.6%, primarily associated with localized pain at the surgical site. All radiographic parameters improved significantly ( p  < 0.001), with values approaching normality in most cases. Conclusion  Improvements in both clinical and radiographic parameters suggest that talocalcaneal arthroereisis corrects deformities with a low complication rate.