Is subtalar extra articular screw arthroereisis (SESA) reducing pain and restoring medial longitudinal arch in children with flexible flat foot?

Subtalar arthroereisis has been accounted for as a minimally invasive, successful and generally safe technique in the treatment of flatfoot in children. The primary aim of our study was to evaluate the subtalar extra-articular screw arthroereisis (SESA) in children with flexible flatfoot clinically and radiologically. This prospective case series study included 84 feet of 42 patients who underwent Subtalar Extra-articular Screw Arthroereisis (SESA) due to symptomatic flexible flatfoot. This study included 26 males (62 ℅) and 16 females (38℅). The mean age at surgery was (9.92 years); range from (7-15 years).The average follow up period was 29.1 months (ranged from 2 to 48 months). The values of the pre- and post-SESA weight bearing X-ray angles were 149 ± 6 and 127° ± 8° respectively for the Costa-Bartani angle, 43° ± 8° and 25° ± 6° respectively for the lateral T-1stMT angle and 26° ± 7° and 8° ± 3° respectively for calcaneal pitch angle 6° ± 4° and 15° ± 5°. The average AOFAS preoperative score was 68.7 ± 5.7 (Range, 58 to 78) whereas post operative AOFAS score was 97.4 ± 2.3 (range, 94 to 100). All data were analyzed statistically with graph instat. With final conclusion that SESA is an optimal technique for the correction of flexible flatfoot (FFF) as it is simple and can be performed rapidly and is effective procedure in reducing pain and restoring medial longitudinal arch in children with flexible flat foot. Level of clinical evidence (LOCE): Level 4.