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International Orthopaedics

, Volume 43, Issue 5, pp 1179–1192 | Cite as

Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review

  • Dong Hun Suh
  • Jung Ho Park
  • Soon Hyuck Lee
  • Hak Jun Kim
  • Young Hwan Park
  • Woo Young Jang
  • Jung Heum Baek
  • Hyun Jae Sung
  • Gi Won ChoiEmail author
Review Article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Flatfoot Subtalar arthroereisis Lateral column lengthening Calcaneal lengthening Children Systematic review 

Notes

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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryKorea University Ansan HospitalAnsan-siSouth Korea
  2. 2.Department of Orthopaedic SurgeryKorea University Anam HospitalSeoulSouth Korea
  3. 3.Department of Orthopaedic SurgeryKorea University Guro HospitalSeoulSouth Korea

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