Published online Jun 18, 2021. doi: 10.5312/wjo.v12.i6.433
Peer-review started: December 1, 2020
First decision: February 15, 2021
Revised: March 21, 2021
Accepted: May 8, 2021
Article in press: May 8, 2021
Published online: June 18, 2021
Flexible flatfoot (FFF) is a common disorder during childhood. When symptoms of early and easy fatigue during walking or pain are present, treatment is mandatory. Arthoereisis (AR) is frequently used for surgical management. Two device types were described, subtalar AR and calcaneo-stop (CS).
No common consensus or AR among orthopedic surgeons is present.
The aim of the study was to report the clinical and radiological outcomes after subtalar AR and CS procedures, including the results in obese and athlete populations, and the technique-related complications. Moreover, the intent was to include the more recent findings of the material devices.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform a systematic review of English-language articles published of the last 5 years.
Seventeen articles were included in the study after the initial screening and the risk of bias assessment. A total of 1864 FFFs were identified. Eight studies evaluated subtalar AR and nine evaluated CS (52.9%). At the start of treatment, the average age of patients was 11.8 years and the average study follow-up was 71.9 mo.
Both AR procedures are valid surgical techniques for FFF treatment, surgeon experience, implant cost, and cosmetic correction were the most common considerations in the orthopedic decision-making process and AR choice. In obese patients, the subtalar AR is not recommended. In adolescents who need to improve sports performance, the CS screw had better results compared with other implants. In adolescents who need to improve sports performance, CS screws had a slightly lower rate of complications than subtalar self-locking implants.
High-quality randomized clinical trials are needed.