Siddabattula Rohit, William Matthew, Pereira Daniel E, Cummings Jason L, Hosseinzadeh Pooya
Department of Orthopaedic Surgery, Washington University in St. Louis, Saint Louis, MO, USA.
Foot Ankle Orthop. 2025 Mar 20;10(1):24730114251318733. doi: 10.1177/24730114251318733. eCollection 2025 Jan.
Calcaneal lengthening osteotomy (CLO) is frequently utilized to treat painful flexible flatfoot (FF) in children. The purpose of this investigation is to analyze the impact of CLO on patient reported pain and mobility using Patient Reported Outcome Measurement Information System (PROMIS) scores in a cohort of pediatric patients treated for painful FF.
Children aged 8-18 who underwent CLO for painful FF correction were included. Retrospective chart review for PROMIS scores of pain and mobility were collected. Preoperative PROMIS scores were compared to PROMIS scores collected within 6-12 months postoperatively. Five PROMIS points was determined to be a minimal clinically significant difference, as this is half of the SD of the PROMIS metric. Preoperative and postoperative AP/lateral talo-first metatarsal angles were collected and compared. The patients with residual pain (PROMIS >55) after CLO were evaluated, and the effect of potential factors on residual postoperative pain was assessed.
Twenty-one patients with 31 feet were included in the study, with an average age of 12.2 (range, 9-15) years at the time of surgery. Mean preoperative pain and mobility PROMIS scores were 53.6 (range, 32.2-69.6) and 42.5 (range, 25.5-56.4), respectively. Mean postoperative pain and mobility PROMIS scores were 47.1 (range, 32.0-59.0) and 48.3 (range, 31.6-61.7), respectively. Patients who received CLO had significant improvement in both pain ( = .005) and mobility ( = .017). Average pain and mobility decreased by 6.51 points and increased by 5.81 points, respectively, after CLO, both clinically significant improvements.
In early follow-up, we found the use of calcaneal lengthening osteotomy used to treat children for painful idiopathic flexible flatfoot to be associated with significant improvements in pain and mobility PROMIS scores.
Level IV, retrospective case series study.
跟骨延长截骨术（CLO）常用于治疗儿童疼痛性柔韧性扁平足（FF）。本研究旨在通过患者报告结局测量信息系统（PROMIS）评分，分析CLO对接受疼痛性FF治疗的儿科患者报告的疼痛和活动能力的影响。
纳入8至18岁因疼痛性FF矫正而接受CLO的儿童。收集PROMIS疼痛和活动能力评分的回顾性病历资料。将术前PROMIS评分与术后6至12个月内收集的PROMIS评分进行比较。将PROMIS评分5分确定为最小临床显著差异，因为这是PROMIS指标标准差的一半。收集并比较术前和术后的前后位/侧位距骨-第一跖骨角。对CLO后仍有疼痛（PROMIS>55）的患者进行评估，并评估潜在因素对术后残留疼痛的影响。
本研究纳入21例患者共31只足，手术时平均年龄为12.2岁（范围9至15岁）。术前疼痛和活动能力的平均PROMIS评分分别为53.6（范围32.2至69.6）和42.5（范围25.5至56.4）。术后疼痛和活动能力的平均PROMIS评分分别为47.1（范围32.0至59.0）和48.3（范围31.6至61.7）。接受CLO的患者在疼痛（P = 0.005）和活动能力（P = 0.017）方面均有显著改善。CLO后平均疼痛评分降低6.51分，活动能力评分增加5.81分，均为具有临床意义的改善。
在早期随访中，我们发现使用跟骨延长截骨术治疗儿童疼痛性特发性柔韧性扁平足与PROMIS疼痛和活动能力评分的显著改善相关。
IV级，回顾性病例系列研究。
