Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review
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This systematic review aimed to compare radiographic correction, clinical outcomes, complications, and re-operations between lateral column lengthening (LCL) and arthroereisis (AR) for treating symptomatic flatfoot in children.
We conducted a comprehensive search on MEDLINE, EMBASE, and Cochrane Library databases. Literature search, data extraction, and quality assessment were conducted by two independent reviewers. The outcomes analyzed included radiographic parameters, clinical scores, satisfaction, complications, and re-operations.
Twenty-one and 13 studies were included in the LCL and AR groups, respectively. The change in anteroposterior talo-first metatarsal angle was greater in the LCL (9.5° to 21.7°) than in the AR group (10.6° to 12.8°). The change in calcaneal pitch was greater in the LCL (2.1° to 26.53°) than in the AR group (− 1.3° to 3.23°). Improvements in the American Orthopedic Foot and Ankle Society (AOFAS) ankle–hindfoot score were greater in the LCL (27.7 to 39.1) than in the AR group (17 to 22). The percentage of satisfaction was similar between the LCL (68% to 89%) and AR (78.5% to 96.4%) groups. The complication rate was higher in the LCL (0% to 86.9%) than in the AR group (3.5% to 45%). The most common complications were calcaneocuboid subluxation and persistent pain in the LCL and AR groups, respectively. The re-operation rate was similar between the LCL (0% to 27.3%) and AR (0% to 36.4%) groups.
The LCL group has achieved more radiographic corrections and more improvements in the AOFAS score than the AR group. Complications were more common in the LCL group than in the AR group, and the re-operation rates were similar between the two groups.
KeywordsFlatfoot Subtalar arthroereisis Lateral column lengthening Calcaneal lengthening Children Systematic review
- 8.Moraleda L, Salcedo M, Bastrom TP, Wenger DR, Albinana J, Mubarak SJ (2012) Comparison of the calcaneo-cuboid-cuneiform osteotomies and the calcaneal lengthening osteotomy in the surgical treatment of symptomatic flexible flatfoot. J Pediatr Orthop 32:821–829. https://doi.org/10.1097/BPO.0b013e3182648c74 CrossRefPubMedGoogle Scholar
- 15.Martinkevich P, Rahbek O, Stilling M, Pedersen LK, Gottliebsen M, Soballe K, Moller-Madsen B (2016) Is structural hydroxyapatite tricalcium-phosphate graft or tricortical iliac crest autograft better for calcaneal lengthening osteotomy in childhood? Interim results from a randomised, controlled non-inferiority study. Bone Joint J 98-B:1554–1562CrossRefPubMedGoogle Scholar
- 16.Westberry DE, Davids JR, Anderson JP, Pugh LI, Davis RB, Hardin JW (2013) The operative correction of symptomatic flat foot deformities in children: the relationship between static alignment and dynamic loading. Bone Joint J 95-B:706–713. https://doi.org/10.1302/0301-620X.95B5.30594 CrossRefPubMedGoogle Scholar
- 18.Rhodes J, Mansour A, Frickman A, Pritchard B, Flynn K, Pan Z, Chang F, Miller N (2017) Comparison of allograft and bovine xenograft in calcaneal lengthening osteotomy for flatfoot deformity in cerebral palsy. J Pediatr Orthop B 37:e202–e208. https://doi.org/10.1097/BPO.0000000000000822 CrossRefGoogle Scholar
- 20.Kim JR, Shin SJ, Wang SI, Kang SM (2013) Comparison of lateral opening wedge calcaneal osteotomy and medial calcaneal sliding-opening wedge cuboid-closing wedge cuneiform osteotomy for correction of planovalgus foot deformity in children. J Foot Ankle Surg 52:162–166. https://doi.org/10.1053/j.jfas.2012.12.007 CrossRefPubMedGoogle Scholar
- 26.Dogan A, Zorer G, Mumcuoglu EI, Akman EY (2009) A comparison of two different techniques in the surgical treatment of flexible pes planovalgus: calcaneal lengthening and extra-articular subtalar arthrodesis. J Pediatr Orthop B 18:167–175. https://doi.org/10.1097/BPB.0b013e32832c2f32 CrossRefPubMedGoogle Scholar
- 38.Viladot A (1992) Surgical treatment of the child’s flatfoot. Clin Orthop Relat Res:34–38Google Scholar
- 50.Yasui Y, Tonogai I, Rosenbaum AJ, Moore DM, Takao M, Kawano H, Kennedy JG (2017) Use of the arthroereisis screw with tendoscopic delivered platelet-rich plasma for early stage adult acquired flatfoot deformity. Int Orthop 41:315–321. https://doi.org/10.1007/s00264-016-3349-2 CrossRefPubMedGoogle Scholar
- 52.Bourlez J, Joly-Monrigal P, Alkar F, Laborde A, Cottalorda J, Louahem D, Delpont M (2018) Does arthroscopic resection of a too-long anterior process improve static disorders of the foot in children and adolescents? Int Orthop 42:1307–1312. https://doi.org/10.1007/s00264-017-3740-7 CrossRefPubMedGoogle Scholar