Analysis of Short-Term Outcome of Osteotomy Combining with Soft Tissue Surgery in the Treatment of Symptomatic Children with Flexible Flatfoot

CATEGORY: Hindfoot; Other INTRODUCTION/PURPOSE: To evaluate the short-term curative effect of clinical results and imaging of osteotomy and soft tissue surgery for the treatment of children with flexible flatfoot. METHODS: From July 2014 to October 2016, 28 patients (47 feet) with flexible flatfoot were treated with osteotomy combining with soft tissue surgery, included 16 males (26 feet) and 12 females (21 feet) with the average age of (11.7+-2.1) years old ranging from 9 to 14 years old. The VAS score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, Maryland score were evaluated before and after the operation to study the clinical effect. Patient satisfaction was also investigated at the end of the follow-up. The talo-navicular coverage angle (TNCA), the talo-1st metatarsal angle (T1MA), the talo-2nd metatarsal angle (T2MA) in the weight-bearing anteroposterior view and the calcaneal inclination angle (Pitch angle), the talo-1st metatarsal angle (Meary’s angle), the talo-calcaneal angle (Kite angle) and final follow-up time to study the imaging data. RESULTS: Superficial tissue infection occurred in 2 cases (3 feet) after surgery, wound healing was achieved through debridement and short-term oral antibiotics. The average VAS score of the final follow-up was significantly lower than that before surgery (P < 0.01). The average AOFAS score and the average Maryland score were significantly higher than pre-operation (P < 0.01). Patient satisfaction at the last follow-up: very satisfaction 20 (71.43%), satisfaction 7 (25%), general 1 (3.57%). The the talo-navicular coverage angle (TCA) ,the talo-1st metatarsal angle (T1MA), the talo-2nd metatarsal angle (T2MA) in the weight-bearing anteroposterior view of the final follow-up were significantly improved compared with preoperation (P＜0.01), the Pitch Angle, Meary’s Angle and Kite Angle in the weight-bearing lateral view ere significantly improved compared with preoperation (P＜0.05). CONCLUSION: Osteotomy combined with soft tissue surgery has good short-term effect on children’s flexible flatfoot, and the effect of correction of malformation is obvious, but the medium-term and long-term effects need to be further studied.