MINIMALLY INVASIVE PROCEDURE FOR THE CORRECTION OF SYMPTOMATIC FLEXIBLE FLATFOOT IN CHILDREN

Abstract

Aim: To evaluate the medium-term results of subtalar arthroereisis for the treatment of flexible flatfoot in children and adolescents.

             Materials and Methods: The study includes 117 feet in 61 patients (mean age 13.27 ± 2.41 years), operated on between 2015 and 2024. The same surgical technique involving the placement of a titanium non-absorbable implant in the sinus tarsi was used in all patients. Preoperative and postoperative radiographic angular measurements of the Talo-Navicular Coverage Angle (TNCA), Calcaneal Inclination Angle (CIA), and Meary’s Angle (MA) were used to assess the results.

       Results: The mean follow-up period was 15.31 ± 6.46 months (min – 8 months). Statistically significant correction (p<0.001) was observed in all examined parameters. The mean value of TNCA decreased from 15.39° to 7.21°, CIA increased from 11.57° to 20.36°, and Meary’s Angle was reduced from 12.77° to 6.21°. A total of 14.5% (17 cases) of complications were reported during the follow-up period.

Conclusion: The operative technique provides secure anatomical and biomechanical correction of symptomatic flatfoot in children, with restoration of the medial longitudinal arch and reduction of the hindfoot valgus position. Subtalar arthroereisis establishes itself as an effective minimally invasive method allowing for rapid patient recovery.