Efficacy of the anterograde calcaneo-stop method in the management of flexible flatfoot in children

Koshman G. Alexeevich; Naveen D. K. N. Direcksze; Prithvi A. Dineshkumar; Kirisayon Yogarajah; Mohamed A. A. Rumi; Jayasooriya P. D. I. Ariyarathna; Arjuna P. Vitharana

doi:10.18203/issn.2455-4510.IntJResOrthop20251787

Authors

Koshman G. Alexeevich Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus https://orcid.org/0000-0001-7451-1282
Naveen D. K. N. Direcksze Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus https://orcid.org/0009-0005-5714-0105
Prithvi A. Dineshkumar Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus
Kirisayon Yogarajah Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus
Mohamed A. A. Rumi Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus
Jayasooriya P. D. I. Ariyarathna Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus
Arjuna P. Vitharana Department of Traumatology, Orthopedics and Military Field Surgery, Grodno State Medical University, Belarus

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251787

Keywords:

Flexible flatfoot, Cancellous screws, Talus, Pediatric orthopedics, Calcaneo-stop procedure

Abstract

Background: Flexible flatfoot is one of frequent foot deformity among pediatric population. The calcaneo-stop procedure has been reported to be effective in short-term studies when conservative treatment is not successful. The aim of this study to evaluate the efficacy after removal of screws following the anterograde calcaneo-stop procedure in the treatment of flexible flatfoot in children.

Methods: This retrospective study consists of 260 calcaneo-stop procedures performed from the period of January 2016 to December 2024 in 65 patients (130 anterograde calcaneo-stop surgeries and 130 removals of calcaneo-stop implant surgeries), which were evaluated clinically, and instrumental diagnostic techniques such as radiography, photoplantography and pedobarography were implemented. The inclusion criteria of this study consist of patients with symptomatic flexible flatfoot, patients with ages from 6 to 14 years, patients with informed consent, patients with negative Wynne-Davies joint hypermobility test and the exclusion criteria of this study includes the following; patients with ages below 6 years and above 14 years, the time elapsed of 3 years after screw implantation, patients with other skeletal deformities, patients without informed consent.

Results: Out of the 130 surgical interventions performed on bilateral flexible flatfoot, which were evaluated in 65 patients after removal the screws following the anterograde calcaneo-stop procedure, revealed no signs of loss correction; which were further evaluated by radiography, photoplantography and pedobarography.

Conclusions: The calcaneo-stop procedure is the least invasive and simplest surgical treatment for symptomatic flexible flatfoot in children. The collected data indicated a sufficiently high efficiency of anterograde calcaneo-stop method in the treatment of flexible flatfoot in children.

Metrics

Metrics Loading ...

References

Jordan KP, Kadam UT, Hayward R, Porcheret M, Young C, Croft P. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord. 2010;11(144):1-10. DOI: https://doi.org/10.1186/1471-2474-11-144

Harris EJ. The natural history and pathophysiology of flexible flatfoot. Clin Podiatr Med Surg. 2010;27(1):1-23. DOI: https://doi.org/10.1016/j.cpm.2009.09.002

El O, Akcali O, Kosay C, Kaner B, Arslan Y, Sagol E, et al. Flexible flatfoot and related factors in primary school children: a report of a screening study. Rheumatol Int. 2006;26(11):1050-3. DOI: https://doi.org/10.1007/s00296-006-0128-1

Lee MS, Vanore JV, Thomas JL, Catanzariti AR, Kogler G, Kravitz SR, et al; Clinical Practice Guideline Adult Flatfoot Panel. Diagnosis and treatment of adult flatfoot. J Foot Ankle Surg. 2005;44(2):78-113. DOI: https://doi.org/10.1053/j.jfas.2004.12.001

Pinney SJ, Lin SS. Current concept review: acquired adult flatfoot deformity. Foot Ankle Int. 2006;27(1):66-75. DOI: https://doi.org/10.1177/107110070602700113

Jane MacKenzie A, Rome K, Evans AM. The efficacy of nonsurgical interventions for pediatric flexible flat foot: a critical review. J Pediatr Orthop. 2012;32(8):830-4. DOI: https://doi.org/10.1097/BPO.0b013e3182648c95

Wenger DR, Mauldin D, Speck G, Morgan D, Lieber RL. Corrective shoes and inserts as treatment for flexible flatfoot in infants and children. J Bone Joint Surg Am. 1989;71(6):800-10. DOI: https://doi.org/10.2106/00004623-198971060-00002

Whitford D, Esterman A. A randomized controlled trial of two types of in-shoe orthoses in children with flexible excess pronation of the feet. Foot Ankle Int. 2007;28(6):715-23. DOI: https://doi.org/10.3113/FAI.2007.0715

Staheli LT. Planovalgus foot deformity. Current status. J Am Podiatr Med Assoc. 1999;89(2):94-9. DOI: https://doi.org/10.7547/87507315-89-2-94

Blitz NM, Stabile RJ, Giorgini RJ, DiDomenico LA. Flexible pediatric and adolescent pes planovalgus: conservative and surgical treatment options. Clin Podiatr Med Surg. 2010;27(1):59-77. DOI: https://doi.org/10.1016/j.cpm.2009.09.001

Hazany S, Ly N, Hazany D, Bader S, Ostuka N. Outcomes of subtalar arthroereisis for the planovalgus foot. J Surg Orthop Adv. 2012;21(3):147-50. DOI: https://doi.org/10.3113/JSOA.2012.0147

Halabchi F, Mazaheri R, Mirshahi M, Abbasian L. Pediatric flexible flatfoot; clinical aspects and algorithmic approach. Iran J Pediatr. 2013;23(3):247-60.

Dibello D, Di Carlo V, Pederiva F. Are Pedobarographic and Gait Analyses Useful Tools to Evaluate Outcomes of Anterograde Calcaneo-Stop Procedure in Pediatric Symptomatic Flexible Flatfoot? Children (Basel). 2022;9(3):366. DOI: https://doi.org/10.3390/children9030366

Giannini S, Cadossi M, Mazzotti A, Persiani V, Tedesco G, Romagnoli M, et al. Bioabsorbable Calcaneo-Stop Implant for the Treatment of Flexible Flatfoot: A Retrospective Cohort Study at a Minimum Follow-Up of 4 Years. J Foot Ankle Surg. 2017;56(4):776-82. DOI: https://doi.org/10.1053/j.jfas.2017.02.018

Roth S, Sestan B, Tudor A, Ostojic Z, Sasso A, Durbesic A. Minimally invasive calcaneo-stop method for idiopathic, flexible pes planovalgus in children. Foot Ankle Int. 2007;28(9):991-5. DOI: https://doi.org/10.3113/FAI.2007.0991

Kellermann P, Roth S, Gion K, Boda K, Tóth K. Calcaneo-stop procedure for paediatric flexible flatfoot. Arch Orthop Trauma Surg. 2011;131(10):1363-7. DOI: https://doi.org/10.1007/s00402-011-1316-3

Dibello D, Dallan G, Di Carlo V, Pederiva F. Quality of life in flexible painful flatfoot treated by anterograde calcaneo-stop procedure: The patient's and family's perspective. PLoS One. 2023;18(2):e0263763. DOI: https://doi.org/10.1371/journal.pone.0263763

Galán-Olleros M, Del Baño Barragán L, Figueroa MJ, Prato de Lima CH, Fraga-Collarte M, Torres-Izquierdo B, et al. Outcomes of the "Calcaneo-stop" procedure for treating symptomatic flexible flatfoot in children: A systematic review and meta-analysis of 2394 feet. Foot Ankle Surg. 2024;30(7):535-45. DOI: https://doi.org/10.1016/j.fas.2024.04.011