J Korean Foot Ankle Soc.  2015 Dec;19(4):176-180. 10.14193/jkfas.2015.19.4.176.

Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot

• Lee K
• Nam YJ

• KMID: 2132461
• DOI: http://doi.org/10.14193/jkfas.2015.19.4.176

Abstract

PURPOSE
The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot.
MATERIALS AND METHODS
Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed.
RESULTS
Clinically, AOFAS ankle-hindfoot scale improved from 70.3+/-5.6 to 97.3+/-2.5 and VAS improved from 6.4+/-1.6 to 0.2+/-0.4. Radiographically, talonavicular coverage angle improved from 28.3degrees+/-12.3degrees to 10.9degrees+/-8.1degrees, lateral talo-first metatarsal angle improved from -19.3degrees+/-9.0degrees to -2.4degrees+/-8.1degrees, and hindfoot alignment angle improved from valgus 11.9degrees+/-10.0degrees to 3.5degrees+/-4.3degrees at minimum 2-year follow-up. No complications occurred postoperatively.
CONCLUSION
Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

Keyword

Flatfoot; Pediatric; Arthroereisis; Calcaneo-stop

MeSH Terms

Ankle
Child
Flatfoot*
Follow-Up Studies
Foot
Humans
Metatarsal Bones
Retrospective Studies

Figure

• 

  Figure 1. (A) Preoperative weightbearing anteroposterior radiograph of 11-year-old boy shows abnormal talonavicular coverage angle of 28o. (B) Preoperative weightbearing lateral radiograph shows decreased lateral talo-first metatarsal angle of ―26o. (C) Preoperative Saltzman's alignment view shows heel alignment angle of valgus 25o.

• 

  Figure 2. Calcaneo-stop procedure was performed and postoperative radiograph was taken at 2-year follow-up. (A) weightbearing anteroposterior radiograph shows normal talonavicular coverage angle of 7o. (B) weightbearing lateral radiograph shows improved lateral talo-first metatarsal angle of 1o. (C) Saltzman's alignment view shows heel alignment angle of valgus 4o.

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