Fu Shaoling, Wu Chenglin, Wang Cheng, Wang Jiazheng, Shi Zhongmin
Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai, China.
Orthop Surg. 2025 Jan;17(1):181-191. doi: 10.1111/os.14285. Epub 2024 Nov 6.
Flatfoot is a common foot disorder involving progressive foot deformity of the three-dimensional structures of the forefoot, midfoot, and hindfoot. Currently, Chinese surgeons and patients favor subtalar arthroereisis (SA) due to its minimally invasive and low-damage characteristics. HyProCure device is widely used. However, there is limited analysis of large sample sizes. This study utilized statistical evaluation with a large sample size to analyze clinical characteristics trends of SA for flatfoot, including baseline indicators, selection of HyProCure size and surgical strategy, complications, and implant removal. This study will enhance the understanding of SA in China.
A retrospective analysis of 732 patients (1008 ft) who underwent SA from June 2015 to June 2023, with 509 pediatric and adolescent patients (772 ft) and 223 adult patients (236 ft). Based on the patient's age, patients aged ≤ 18 were included in the children and adolescent group, while adult acquired flatfoot deformity (AAFD) patients aged > 18 were included in the adult group. General data was collected, including patient sex, age, side, body mass index (BMI), surgery date, HyproCure size, and surgical data, and trends were analyzed. Postoperative complications and HyProCure removal were collected as outcome measures during follow-up.
The age of patients treated with SA was gradually getting younger, with male patients predominating, mainly concentrated in the 11-14 age group. HyProCure 7 has the highest usage rate. In the children and adolescent group, 288 ft (37.31%) only underwent SA. In the adult group, 18 ft (7.63%) only underwent SA. Complications include sinus tarsi pain, peroneal spasms, achilles tendon tension, and muscle strength decline. The complication rate in the children and adolescent group was 5.05%, while in the adult group it was 28.81%. Overall, it was 10.62%. The removal rate of HyProCure in the children and adolescent group is 1.04%, in the adult group is 15.25%, and overall is 4.37%.
The trend in flatfoot treated with SA was towards children and adolescent male patients, and sinus tarsi pain was the most common complication after SA. The complication rate and removal rate in the children and adolescent group were lower than those in the adult group. HyProCure can be removed without additional adverse effects.
扁平足是一种常见的足部疾病，涉及前足、中足和后足三维结构的渐进性足部畸形。目前，由于其微创和低损伤的特点，中国外科医生和患者更倾向于距下关节制动术（SA）。HyProCure装置被广泛使用。然而，大样本量的分析有限。本研究采用大样本量的统计评估来分析SA治疗扁平足的临床特征趋势，包括基线指标、HyProCure尺寸的选择和手术策略、并发症以及植入物取出。本研究将增进中国对SA的理解。
对2015年6月至2023年6月期间接受SA治疗的732例患者（1008足）进行回顾性分析，其中儿童和青少年患者509例（772足），成人患者223例（236足）。根据患者年龄，年龄≤18岁的患者纳入儿童和青少年组，而年龄>18岁的成人获得性平足畸形（AAFD）患者纳入成人组。收集一般资料，包括患者性别、年龄、患侧、体重指数（BMI）、手术日期、HyproCure尺寸和手术数据，并分析趋势。随访期间收集术后并发症和HyProCure取出情况作为结局指标。
接受SA治疗的患者年龄逐渐年轻化，男性患者居多，主要集中在11 - 14岁年龄组。HyProCure 7的使用率最高。在儿童和青少年组中，288足（37.31%）仅接受了SA。在成人组中，18足（7.63%）仅接受了SA。并发症包括跗骨窦疼痛、腓骨痉挛、跟腱紧张和肌肉力量下降。儿童和青少年组的并发症发生率为5.05%，而成人组为28.81%。总体而言，为10.62%。儿童和青少年组HyProCure的取出率为1.04%，成人组为15.25%，总体为4.37%。
SA治疗扁平足的趋势是儿童和青少年男性患者，跗骨窦疼痛是SA后最常见的并发症。儿童和青少年组的并发症发生率和取出率低于成人组。HyProCure可以取出且无额外不良反应。
