M Abbara-Czardybon1, D Frank, D Arbab. 1. Klinik für Orthopädie, Unfallchirurgie und Handchirurgie, Florence Nightingale Krankenhaus, Kreuzbergstr. 79, 40489, Düsseldorf, Deutschland, abbara@kaiserswerther-diakonie.de.
Abstract
OBJECTIVE: Pain relief by realignment of the hindfoot and blocking excessive pronation through insertion of a screw into the lateral aspect of the calcaneus in juvenile pes planovalgus. INDICATIONS: Symptomatic juvenile flatfoot (9-13 years). CONTRAINDICATIONS: Congenital, fixed and secondary (neuromuscular disorder) flatfoot deformities. SURGICAL TECHNIQUE: Incision at the lateral aspect of the sinus tarsi. Guide wire insertion into the lowest point of the lateral anterior calcaneus (fluoroscopy). Drilling (3.2 mm) and insertion of a 6.5-7.0 mm cancellous screw. The screw head impinges against the lateral aspect of the talus and prevents excessive eversion. POSTOPERATIVE MANAGEMENT: Compression dressing. Full weight bearing allowed. No sports activity for 4 weeks. RESULTS: Between 2002 and 2011, the technique was used in 35 children (68 feet; mean age 10 years). Complications were peroneal spasms, overcorrections, wound healing problems and local tenderness. Tarsometatarsal and calcaneal pitch angle improved significantly. The procedure is a reliable method for the correction of flexible juvenile flatfeet allowing "growth adjustment" of the subtalar joint.
OBJECTIVE:Pain relief by realignment of the hindfoot and blocking excessive pronation through insertion of a screw into the lateral aspect of the calcaneus in juvenile pes planovalgus. INDICATIONS: Symptomatic juvenile flatfoot (9-13 years). CONTRAINDICATIONS: Congenital, fixed and secondary (neuromuscular disorder) flatfoot deformities. SURGICAL TECHNIQUE: Incision at the lateral aspect of the sinus tarsi. Guide wire insertion into the lowest point of the lateral anterior calcaneus (fluoroscopy). Drilling (3.2 mm) and insertion of a 6.5-7.0 mm cancellous screw. The screw head impinges against the lateral aspect of the talus and prevents excessive eversion. POSTOPERATIVE MANAGEMENT: Compression dressing. Full weight bearing allowed. No sports activity for 4 weeks. RESULTS: Between 2002 and 2011, the technique was used in 35 children (68 feet; mean age 10 years). Complications were peroneal spasms, overcorrections, wound healing problems and local tenderness. Tarsometatarsal and calcaneal pitch angle improved significantly. The procedure is a reliable method for the correction of flexible juvenile flatfeet allowing "growth adjustment" of the subtalar joint.
Authors: Sandor Roth; Branko Sestan; Anton Tudor; Zdenko Ostojic; Anton Sasso; Artur Durbesic Journal: Foot Ankle Int Date: 2007-09 Impact factor: 2.827