Smith Christian, Zaidi Razi, Bhamra Jagmeet, Bridgens Anna, Wek Caesar, Kokkinakis Michail
Guys and St Thomas NHS Foundation Trust, London, UK.
Evelina Children's Hospital, Westminster Bridge Road, London, UK.
EFORT Open Rev. 2021 Feb 1;6(2):118-129. doi: 10.1302/2058-5241.6.200076. eCollection 2021 Feb.
Subtalar arthroereisis has a controversial history and has previously been associated with high failure rates and excessive complications.A database search for outcomes of arthroereisis for the treatment of symptomatic paediatric flexible pes planus provided 24 articles which were included in this review, with a total of 2550 feet operated on.Post-operative patient-reported outcome measures recorded marked improvement. Patient satisfaction was reported as excellent in 79.9%, and poor in 5.3%. All radiological measurements demonstrated improvement towards the normal range following arthroereisis, as did hindfoot valgus, supination, dorsiflexion and Viladot grade.Complications were reported in 7.1% of cases, with a reoperation rate of 3.1%.Arthroereisis as a treatment for symptomatic paediatric flexible pes planus produces favourable outcomes and high patient satisfaction rates with a reasonable risk profile. There is still a great deal of negativity and literature highlighting the complications and failures of arthroereisis, especially for older implants.The biggest flaws in the collective literature are the lack of high-quality prospective studies, a paucity of long-term data and the heterogeneity of utilized outcome measures between studies. Cite this article: 2021;6:118-129. DOI: 10.1302/2058-5241.6.200076.
距下关节制动术有着颇具争议的历史,此前一直与高失败率和过多并发症相关。一项关于治疗有症状的小儿柔韧性扁平足的关节制动术结果的数据库检索提供了24篇文章,纳入了本综述,共对2550只脚进行了手术。术后患者报告的结局指标显示有显著改善。报告患者满意度极佳的占79.9%,较差的占5.3%。所有影像学测量结果显示关节制动术后均朝着正常范围改善,后足外翻、内旋、背屈和维拉多特分级也是如此。7.1%的病例报告有并发症,再次手术率为3.1%。关节制动术作为治疗有症状的小儿柔韧性扁平足的方法能产生良好的效果和较高的患者满意度,且风险状况合理。关于关节制动术的并发症和失败情况,仍然存在大量负面评价和文献,尤其是针对较旧的植入物。现有文献中最大的缺陷是缺乏高质量的前瞻性研究、长期数据匮乏以及各研究之间所采用结局指标的异质性。引用本文:2021;6:118 - 129。DOI: 10.1302/2058 - 5241.6.200076。