Costa Francisca Pinho, Costa Gilberto, Carvalho Manuel Santos, Moura António Mendes, Pinto Rui, Torres João
Unidade de Ortopedia e Traumatologia. Departamento de Cirurgia. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
Unidade de Ortopedia e Traumatologia. Departamento de Cirurgia. Faculdade de Medicina. Universidade do Porto. Porto. Portugal; Departamento de Ortopedia e Traumatologia. Centro Hospitalar de São João. Porto. Portugal.
Acta Med Port. 2017 Aug 31;30(7-8):541-545. doi: 10.20344/amp.8137.
Flexible flatfoot is common amongst children, although treatment is rarely indicated. The calcaneo-stop procedure has been reported to be effective in short-term studies. We aim to evaluate the long-term outcomes of the calcaneo-stop procedure in the treatment of flexible flatfoot in children.
Twenty-six calcaneo-stop procedures performed between 1995 and 2006 on 13 patients were evaluated clinically and using photopodoscopy, and the FAOS questionnaire was applied for both feet.
Of the 26 feet evaluated, 22 presented with heel valgus, 13 had forefoot supination and 11 had abnormal footprints. Median FAOS questionnaire score was 97.22 for 'Pain', 92.86 for 'Other symptoms', 98.53 for 'Function in daily living', 100 for 'Function in sports and recreation' and 93.75 for 'Foot and ankle-related quality of life'.
The calcaneo-stop procedure is the least invasive and most simple surgical treatment for symptomatic flexible flatfoot in children. Short-term studies report excellent clinical and radiographic results. The authors report alterations in clinical parameters in a large proportion of patients. These findings can be due to biomechanical alterations in the years following removal of the screw. Patient foot and ankle-related satisfaction data is promising, although hard to evaluate given the absence of preoperative data.
Larger, prospective, controlled studies are required to better evaluate the long-term success of this procedure.
柔韧性扁平足在儿童中很常见，尽管很少需要进行治疗。在短期研究中，跟骨阻滞手术已被报道具有疗效。我们旨在评估跟骨阻滞手术治疗儿童柔韧性扁平足的长期效果。
对1995年至2006年间对13例患者实施的26例跟骨阻滞手术进行了临床评估，并使用足光透照法进行检查，同时对双脚应用了足踝功能与健康量表（FAOS）问卷。
在评估的26只脚中，22只存在足跟外翻，13只前足内旋，11只脚印异常。足踝功能与健康量表问卷中，“疼痛”项的中位数得分是97.22，“其他症状”项为92.86，“日常生活功能”项为98.53，“运动和娱乐功能”项为100，“足踝相关生活质量”项为93.75。
跟骨阻滞手术是治疗儿童有症状柔韧性扁平足的侵入性最小且最简单的手术治疗方法。短期研究报告了出色的临床和影像学结果。作者报告了大部分患者临床参数的改变。这些发现可能是由于取出螺钉后的数年中生物力学发生了改变。尽管由于缺乏术前数据难以评估，但患者足踝相关的满意度数据很有前景。
需要开展更大规模的前瞻性对照研究，以更好地评估该手术的长期成功率。
