Herdea Alexandru, Neculai Adrian-Gabriel, Ulici Alexandru
11th Department of Pediatric Orthopedics, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Pediatric Orthopedics Department, Grigore Alexandrescu Children's Emergency Hospital, 011743 Bucharest, Romania.
Children (Basel). 2022 Jun 29;9(7):973. doi: 10.3390/children9070973.
Flexible flatfoot represents one of the most common deformities of the lower limb, affecting children and adolescents. Aesthetic aspect, abnormal gait, pain and fatigue are by far the most important symptoms which determine parents to bring their children to the orthopedist. We set out to conduct a prospective study, case-controlled, including patients with symptomatic flexible flatfeet operated on by arthroereisis surgery and comparing them to a normal feet group of children age- and sex-matched (control group). Minimum follow-up time was 2 years. In total, 33 patients with bilateral arthroereisis were included and 36 patients formed the control group (12.12 +/− 1.85 years vs. 11.81 ± 2.40 years, p = 0.54). Quality of life improved postoperatively (p = 0.18) and was not different from the control group. Median running time improved postoperatively by 2.25 s (p < 0.0001) and got closer to the median running time from the control group (22.30 s compared to 20.94 s, p = 0.01). All radiological angles improved (p < 0.0001), but quality of life improvement was correlated with talonavicular coverage angle and Meary angle measurements. Flatfoot in children and adolescents may be a condition in which the quality of life and sports performance are decreased, compared to healthy children. Arthroereisis is a minimally invasive surgical procedure with a short recovery time and a short period before resumption of sport activities, which can be useful in certain types of flexible flatfoot due to its effectiveness on symptom reduction.
柔韧性扁平足是下肢最常见的畸形之一,影响儿童和青少年。美观、异常步态、疼痛和疲劳是迄今为止最重要的症状,这些症状促使家长带孩子去看骨科医生。我们开展了一项前瞻性病例对照研究,纳入接受关节镜下距下关节制动术治疗的有症状柔韧性扁平足患者,并将他们与年龄和性别匹配的正常足儿童组(对照组)进行比较。最短随访时间为2年。总共纳入了33例接受双侧关节镜下距下关节制动术的患者,36例患者组成对照组(12.12±1.85岁 vs. 11.81±2.40岁,p = 0.54)。术后生活质量有所改善(p = 0.18),且与对照组无差异。术后中位跑步时间改善了2.25秒(p < 0.0001),并更接近对照组的中位跑步时间(从22.30秒降至20.94秒,p = 0.01)。所有影像学角度均有所改善(p < 0.0001),但生活质量的改善与距舟覆盖角和梅里角测量值相关。与健康儿童相比,儿童和青少年的扁平足可能是一种生活质量和运动表现下降的情况。关节镜下距下关节制动术是一种微创手术,恢复时间短,恢复体育活动前的时间短,由于其在减轻症状方面的有效性,对某些类型的柔韧性扁平足可能有用。