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Orthopaedics & Traumatology, Surgery &... Oct 2021The aim of the present systematic literature review was to determine results and complications in subtalar arthroereisis for stage-2 adult-acquired flatfoot. (Review)
Review
INTRODUCTION
The aim of the present systematic literature review was to determine results and complications in subtalar arthroereisis for stage-2 adult-acquired flatfoot.
METHOD
A search of the PubMed, Medline, CINAHL, Cochrane and Embase databases used MeSH terms "arthroereisis" AND "flatfoot" OR "adult-acquired flatfoot" OR "pes planovalgus" OR "pes planus". Two of the authors analyzed 125 articles. After reading titles and Abstracts, 105 articles were read in full text and their references were analyzed. Finally, 12 articles were selected and divided into 2 groups: isolated and associated arthroereisis.
RESULTS
Improvement in functional scores was greater in associated arthroereisis. Whether isolated or associated, arthroereisis achieved radiologic correction. However, the rate of complications was high, mainly concerning tarsal sinus pain.
CONCLUSION
Subtalar arthroereisis for stage-2 adult-acquired flatfoot is rarely performed in isolation. When it is associated to other procedures, good radiologic and clinical results can be expected.
LEVEL OF EVIDENCE
IV.
Topics: Adult; Databases, Factual; Flatfoot; Humans; Orthopedic Procedures; Pain; Radiology; Subtalar Joint
PubMed: 34216843
DOI: 10.1016/j.otsr.2021.103002 -
Orthopaedics & Traumatology, Surgery &... Feb 2019Idiopathic pes planus is common and usually physiologic. Decompensation, when it occurs, may be obvious or on the contrary difficult to identify, raising challenges in... (Review)
Review
Idiopathic pes planus is common and usually physiologic. Decompensation, when it occurs, may be obvious or on the contrary difficult to identify, raising challenges in patient selection for surgical treatment. The physical examination of a child with pes planus must include an evaluation in the supine position, which helps to adjust the amount of correction during surgery. The many reported surgical procedures include repositioning (talus-reseating, subtalar implants and calcaneo-stop screw), osteotomies and joint fusions. The primary treatment goal is to achieve full architectural correction of the deformity. Selection of the procedure depends on patient age and reducibility of the deformity. The joint lines should be preserved whenever possible. Triceps surae contracture should be sought and corrected if found.
Topics: Arthrodesis; Child; Flatfoot; Humans; Joint Prosthesis; Osteotomy; Patient Selection; Physical Examination; Postoperative Care; Preoperative Care; Radiography; Subtalar Joint; Tarsal Bones
PubMed: 29709656
DOI: 10.1016/j.otsr.2018.03.010 -
Journal of Children's Orthopaedics Oct 2022Pes planus (or flatfoot) is the most common deformity in children with cerebral palsy. There are several surgical interventions used to treat it: single calcaneal... (Review)
Review
PURPOSE
Pes planus (or flatfoot) is the most common deformity in children with cerebral palsy. There are several surgical interventions used to treat it: single calcaneal osteotomies, extra-articular arthrodesis, double calcaneal osteotomy, calcaneo-cuboid-cuneiform osteotomy, intra-articular arthrodesis, and arthroereisis. There is currently no evidence on optimal treatment for flatfoot in children with cerebral palsy. Our purpose is to systematically review studies reporting complications, recurrence rates, and radiological outcomes of the surgical management of flatfoot in children with cerebral palsy.
METHODS
Five databases were searched to identify studies published from inception until July 2021, with keywords relating to flatfoot, cerebral palsy, and surgical interventions. We included prospective, retrospective, and comparative study designs in the English language. Data was extracted and tabulated in duplicate into Excel, and analysis was conducted using Python SciPy.
RESULTS
In total, 1220 studies were identified of which 44 met the inclusion criteria, comprising 2234 feet in 1364 patients with a mean age of 10.3 years and mean follow-up of 55.9 months. Radiographic outcomes showed improvement with all procedures; complications and recurrence rates were too poorly reported to compare. Only 6 (14%) studies were assessed as a low risk of bias. There was substantial heterogeneity of outcome measures.
CONCLUSION
There is a lack of high-quality, comparative studies assessing the radiological outcomes, complications, and recurrence rates of surgical alternatives to treat flatfoot in children with cerebral palsy. There is currently no clear evidence on optimal surgical treatment.
LEVEL OF EVIDENCE
IIa based on Oxford Centre for Evidence-based Medicine.
PubMed: 36238147
DOI: 10.1177/18632521221112496 -
Chinese Journal of Traumatology =... Aug 2019Calcaneovalgus foot deformities are present in up to 35% of patients with lumbar spina bifida. Resultant heel weight bearing causes complications include those...
Calcaneovalgus foot deformities are present in up to 35% of patients with lumbar spina bifida. Resultant heel weight bearing causes complications include those associated with pressure ulcers. Early surgical reconstruction is advocated to prevent deformity progression and rigidity. Several surgical techniques in paediatric populations have been described, but there remains a paucity of literature regarding reconstruction of chronic calcaneovalgus feet in adults. This case report describes our experience using the Ilizarov technique in the reconstruction of an adult presenting with chronic calcaneovalgus feet. This is a 34-year-old lady with myelomeningocoele spina bifida of lumbar level 5 who presented with a history of multiple admissions for cellulitis and infections of bilateral heel pressure sores. Rigid calcaneovalgus deformities of both feet (45° on the right, 40° on the left) were noted on clinical examination and radiological investigations. Reconstruction with an Ilizarov frame allowed for gradual correction of both soft tissue and bone, correcting heel weight bearing ambulation, with the aim of preventing further complications from infected heel ulcers. While the correction of bony deformities is crucial, management of chronically contracted soft tissue must not be overlooked. An Ilizarov frame requires both an experienced surgeon and a motivated patient, but it allows for accurate reconstruction of bony deformities, while allowing management of surrounding chronic soft tissue contractures with good functional outcome.
Topics: Adult; Chronic Disease; Female; Flatfoot; Foot Ulcer; Humans; Lumbar Vertebrae; Meningomyelocele; Orthopedic Procedures; Plastic Surgery Procedures; Spinal Dysraphism; Treatment Outcome
PubMed: 31239218
DOI: 10.1016/j.cjtee.2019.04.001 -
Clinical Obesity Apr 2015Children with obesity report musculoskeletal pain more than normal-weight children; this may be linked with literature suggesting children with obesity have higher... (Review)
Review
Children with obesity report musculoskeletal pain more than normal-weight children; this may be linked with literature suggesting children with obesity have higher prevalence of pes planus (flatfoot). To further elucidate whether this relation occurs, we conducted a systematic literature review on the co-occurrence of pes planus and paediatric obesity. Empirical articles published until September 2013 were obtained through an electronic search of MEDLINE and SPORTDiscus; included articles examined the association between body weight and pes planus in children. Thirteen cross-sectional studies of varied designs were identified. Methods used to diagnose pes planus varied between studies: imaging modalities, anthropometric measurements and clinical examination. Across all studies, pes planus prevalence among children with obesity ranged widely from 14 to 67%. Nearly all studies indicated increasing pes planus in children with increasing weight. No studies evaluated pain/complications related to pes planus. Our review suggests increased prevalence of pes planus among children with obesity or increasing weight status. Because of differing methodologies, lack of consensus regarding the pes planus definition, the dearth of investigation into pain/complications and the few existing studies, more research is needed to determine a relation between children's body weight, pes planus and associated effects on pain and function.
Topics: Age Factors; Comorbidity; Flatfoot; Foot; Humans; Pain; Pediatric Obesity; Prevalence
PubMed: 25808780
DOI: 10.1111/cob.12091 -
EFORT Open Reviews Nov 2017Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults.It... (Review)
Review
Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults.It has been described as a standalone or adjunctive procedure, and is indicated in the treatment of flexible flatfoot, tibialis posterior tendon dysfunction, tarsal coalition and accessory navicular syndrome.Different devices for subtalar arthroereisis are currently used throughout the world associated with soft-tissue and bone procedures, depending on the surgeon rather than on standardised or validated protocols.Sinus tarsi pain is the most frequent complication, often requiring removal of the implant.To date, poor-quality evidence is available in the literature (Level IV and V), with only one comparative non-randomised study (Level II) not providing strong recommendations. Long-term outcome and complication rates (especially the onset of osteoarthritis) are still unclear. : 2017;2:438-446. DOI: 10.1302/2058-5241.2.170009.
PubMed: 29218229
DOI: 10.1302/2058-5241.2.170009 -
Children (Basel, Switzerland) Feb 2023Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of... (Review)
Review
Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of conservative and surgical treatments, with foot orthoses (FO) being the first line of treatment due to their lack of contraindications and because the active participation of the child is not required, although the evidence supporting them is weak. It is not clear what the effect of FO is, nor when it is advisable to recommend them. PFF, if left untreated or uncorrected, could eventually cause problems in the foot itself or adjacent structures. It was necessary to update the existing information on the efficacy of FO as a conservative treatment for the reduction in signs and symptoms in patients with PFF, to know the best type of FO and the minimum time of use and to identify the diagnostic techniques most commonly used for PFF and the definition of PFF. A systematic review was carried out in the databases PubMed, EBSCO, Web of Science, Cochrane, SCOPUS and PEDro using the following strategy: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) on child patients with PFF, compared to those treated with FO or not being treated, assessing the improvement of signs and symptoms of PFF. Studies in which subjects had neurological or systemic disease or had undergone surgery were excluded. Two of the authors independently assessed study quality. PRISMA guidelines were followed, and the systematic review was registered in PROSPERO: CRD42021240163. Of the 237 initial studies considered, 7 RCTs and CCTs published between 2017 and 2022 met the inclusion criteria, representing 679 participants with PFF aged 3-14 years. The interventions of the included studies differed in diagnostic criteria, types of FO and duration of treatment, among others. All articles conclude that FO are beneficial, although the results must be taken with caution due to the risk of bias of the included articles. There is evidence for the efficacy of FO as a treatment for PFF signs and symptoms. There is no treatment algorithm. There is no clear definition for PFF. There is no ideal type of FO, although all have in common the incorporation of a large internal longitudinal arch.
PubMed: 36832500
DOI: 10.3390/children10020371 -
Cureus Oct 2023Flatfoot is a common condition among adults, according to orthopedic experts. Flatfoot is defined in this document as a foot condition that occurs after the completion... (Review)
Review
Flatfoot is a common condition among adults, according to orthopedic experts. Flatfoot is defined in this document as a foot condition that occurs after the completion of skeletal growth and is characterized by either partial or complete reduction of the medial longitudinal arch (MLA). The purpose of this study was to evaluate the effects of short foot exercise (SFE) and faradic foot baths on people who have flat feet. This review focused on comprehensive original primary articles written in English. Numerous studies have been conducted in order to determine the effects of both interventions. The search yielded a wide range of papers, including editorials, review articles, freely available full texts, and abstracts. The results showed that both SFE and faradic foot baths effectively improved flat feet.
PubMed: 38021688
DOI: 10.7759/cureus.47803 -
International Journal of Environmental... Sep 2022Pes planus, one of the most common foot deformities, includes the loss of the medial arch, misalignment of the rearfoot, and abduction of the forefoot, which negatively...
Pes planus, one of the most common foot deformities, includes the loss of the medial arch, misalignment of the rearfoot, and abduction of the forefoot, which negatively affects posture and gait. Foot orthosis, which is effective in normalizing the arch and providing stability during walking, is prescribed for the purpose of treatment and correction. Currently, machine learning technology for classifying and diagnosing foot types is being developed, but it has not yet been applied to the prescription of foot orthosis for the treatment and management of pes planus. Thus, the aim of this study is to propose a model that can prescribe a customized foot orthosis to patients with pes planus by learning from and analyzing various clinical data based on a decision tree algorithm called classification and regressing tree (CART). A total of 8 parameters were selected based on the feature importance, and 15 rules for the prescription of foot orthosis were generated. The proposed model based on the CART algorithm achieved an accuracy of 80.16%. This result suggests that the CART model developed in this study can provide adequate help to clinicians in prescribing foot orthosis easily and accurately for patients with pes planus. In the future, we plan to acquire more clinical data and develop a model that can prescribe more accurate and stable foot orthosis using various machine learning technologies.
Topics: Biomechanical Phenomena; Decision Trees; Flatfoot; Foot Orthoses; Humans; Prescriptions
PubMed: 36231782
DOI: 10.3390/ijerph191912484 -
Journal of Medical Genetics Oct 1982The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the...
Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis).
The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Register control group of 692 normal infants born over the same period, giving a unique opportunity to obtain more accurate antenatal data than has previously been possible. The principal associations were: talipes equinovarus with antepartum haemorrhage and maternal hypertension; metatarsus varus with twin pregnancies; congenital dislocation of the hip with first born children, older than average fathers, breech presentation, a significant lack of menstrual problems in the mother, and maternal upper respiratory infection during pregnancy; infantile idiopathic scoliosis with breech presentation, prematurity, and the onset of the curve in the winter months. No significant association with raised intrauterine pressure (hydramnios or oligohydramnios) was found among these simple idiopathic deformities. It is concluded that the multifactorial genetic background in likely to be similar in all, but that the additional environmental element is variable.
Topics: Adult; Birth Order; Breech Presentation; Clubfoot; Environment; Female; Hip Dislocation, Congenital; Humans; Infant, Newborn; Male; Metatarsus; Paternal Age; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Infectious; Pregnancy, Multiple; Registries; Scoliosis; Scotland; Seasons
PubMed: 7143383
DOI: 10.1136/jmg.19.5.321