Comparison between Malerba osteotomy and combined Evans/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: a prospective randomised control trial, three years follow-up

Nagy, M; Kholeif, Ahmed; Mansour, Ali; Abdelhameed, Samar; Radwan, Yasser; Khedr, Ahmed; Elhalawany, Ahmed S.; Samir, Ahmed; Sarhan, Islam; Zein, Abo Bakr

doi:10.1007/s00264-021-05172-5

Cited by 2 publications

(3 citation statements)

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“…Systematic reviews and meta-analyses of common adult pathologies such as anterior cruciate ligament injuries and arthroplasties frequently include more than 20 studies, and usually several with high evidence levels ( 40 - 43 ). Furthermore, there are only a few randomized controlled trials on treatment of FFF, all with short-to-mid-term follow-up only ( 23 , 24 , 44 - 46 ); therefore they were not considered in this systematic review with a focus on long-term effects. Albeit based on retrospective, non-randomized cohort studies, the pooled results herein following surgery for symptomatic FFF appear promising in terms of complications and radiological outcome.…”

Section: Discussionmentioning

confidence: 99%

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Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review

Smolle

Švehlík

Regvar

et al. 2022

ActaO

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Background and purpose: Albeit pediatric flexible flat foot (FFF) is a common condition, only a minority of patients become symptomatic. Long-term outcomes of surgically treated pediatric patients with symptomatic FFF are largely unknown. In this systematic review, studies providing outcomes at a mean follow-up of at least 4 years after the procedure in these patients were analyzed. Material and methods: A PubMed search was undertaken involving original articles published up to July 2021 on outcome in children aged 6 to 14 with surgically treated FFF and mean (or minimum) follow-up of at least 4 years. Radiographic and clinical outcomes were analyzed. Results: Of initially 541 entries, 10 could be included in the systematic review (all level IV), involving 846 pediatric patients with 1,536 symptomatic FFF. Pooled mean radiological (n = 8) and clinical follow-up (n = 10) was 5.3 (range 0.5–15) and 7.0 (range 4.1–15) years, respectively. Surgical procedures included arthroereisis (n = 8), lateral column lengthening (n = 1), and Horseman procedure (n = 1). Overall relative frequency of implant-associated complications and wound-healing problems was 3.2% and 1.3%, as well as 2.8% and 1.6% following subtalar arthroereisis only. From preoperative to latest radiological assessment following subtalar arthroereisis (including 3 studies with radiological follow-up < 48 months), pooled median decrease in talonavicular coverage angle (TNCA; –9.2°), anteroposterior talocalcaneal angle (A-TCA; –6.5°), lateral talocalcaneal angle (L-TCA; –3.5°), talar declination angle (TDA; –14°),Moreau Costa Bertani angle (MCB; –13°), and talo-firstmetatarsal angle (L-T1MA; –10°) was observed, as was an increase in calcaneal pitch (4.5°). Interpretation: In symptomatic pediatric FFF patients, surgery is associated with a manageable complication profile, and results in satisfactory long-term clinical as well as radiological outcome. Yet scientific evidence is low, warranting larger scaled studies in the future.

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Section: Discussionmentioning

confidence: 99%

“…Whilst short-term effects—also within randomized controlled trials ( 23 , 24 )—are frequently reported after surgical treatment of FFF, only a few studies have concentrated on long-term results, with often non-standardized and heterogeneous assessment of outcomes ( 6 , 25 , 26 ).…”

mentioning

confidence: 99%

Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review

Smolle

Švehlík

Regvar

et al. 2022

ActaO

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“…Nagy et al showed a very good result for Evans osteotomy in pes planus, with 17 cases without non-union. They used screws for fixation [14]. Nejib et al used K-wires for lengthening calcaneal surgeries with good clinical and radiological results.…”

Section: Introductionmentioning

confidence: 99%

K-Wire Osteosynthesis for Arthrodesis of the Paediatric Foot Is a Good and Valid Procedure

Kreher,

Putz,

Fackler

et al. 2023

JCM

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Background: Foot deformities in children are common, and the majority can be treated conservatively. Nevertheless, there are deformities that require surgical treatment. These include rigid clubfeet, severe forms of pes planovalgus, pes cavus and several more. We retrospectively analysed the pseudarthrosis rate of surgical treatment of foot deformities with transcutaneous K-wire osteosynthesis in neurologically healthy children and adolescents. The aim of the study was to show that the results with K-wires are comparable to those with other osteosynthesis methods in the literature. Methods: A total of 46 paediatric patients aged 6 to 17 years treated between January 2010 and December 2015 met the inclusion criteria. Depending on the diagnosis, different surgical interventions were necessary. In clubfoot and pes planovalgus, representing n = 81, 70% of the whole collective triple arthrodesis with fusion of the talonavicular, calcaneocuboid and subtalar joints or Evans osteotomy was usually performed. Radiographs were taken at least 6 months post-surgery, and bony consolidation of the subtalar, talonavicular (TN), and calcaneocuboidal (CC) joints and the metatarsal I (MT I) osteotomy were assessed. If there was no evidence of fusion at this time, it was considered non-union. Results: In total, 117 arthrodesis procedures with K-wires were performed. Overall, 110 of the arthrodesis (94%) healed, and only 7 joints (6%) showed non-union (subtalar 0%, TN 7.7%, CC 6.5% and MT I 6.7%). All non-unions occurred in subjects with clubfoot deformities. No significant risk factors were observed. Conclusion: This study replicated the good consolidation rates reported in the literature with screws, plates, intramedullary nails or staples in arthrodesis of the adolescent foot in neurologically healthy subjects and confirmed the efficacy of K-wires. The main advantages of transcutaneous K-wire treatment are easy metal removal, lower osteosynthesis material costs and less concomitant damage. Further studies, especially randomised controlled trials, are needed to further investigate this topic.

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Comparison between Malerba osteotomy and combined Evans/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: a prospective randomised control trial, three years follow-up

Cited by 2 publications

References 12 publications

Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review

Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review

K-Wire Osteosynthesis for Arthrodesis of the Paediatric Foot Is a Good and Valid Procedure

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