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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2004 September;28(3):107-18
Treatment of flat foot of adolescent by calcaneostop and medial tendon-glenoid-ligamnetous plastic. Casistic review
De Pasquali P. M., Fullone F. W.
Aim. Various treatment methods have been proposed for flat foot of adolescent. Is actually in common use the Subtalar Arthrorisis with Calcaneostop, associated or not with others operations on the soft tissues. In this paper the authors describes the results obtained using medial tendon-glenoid-ligamentous plastic as described by Pisani, associated to Calcaneostop.
Methods. Thirty-five feet of 24 patients treated from 2000 to 2002 at the «ICOT» was esaminated; the mean follow-up period was 28 months, the mean age of the study group was 11,4 years.
Results. The results was evaluated clinically or by diagnostic imaging and written questionnaires; the patient's satisfaction was asked, as the availability to an analogous operation. ROM of Subtalar joint was reduced in 8.6%; a tarsal pain, more often lateral and slight, remained in 28.6%. Patients was very satisfied in 74.3%, and quite satisfied in 25.7%; no one of them was not very or totally unsatisfied. An analogous operation should be accepted by 88,6%, and not accepted by 11.4%. Complication was: a lateral pain during two years, till the screw's remotion; 3 varus overcorrection, solved in a case with the screw substitution with a smaller one, and in two cases with the sinking of the screw.
Conclusion. The Subtalar Arthrorisis with Calcaneostop with medial tendon-glenoid-ligamentous plastic as described by Pisani for the flat foot of adolescent is a simple, sure, and complicationless tecnique, that needs however accurate diagnosis and non standardized chirurgical planning. It's important to choose the cases needing the medial plastic besides the simple arthrorisis. The Achille's tendon non-lenghtening may compromise the valgous correction, and the final result too; same attention must be payd to the shortness of anterior tibialis' tendon and to the deformity structuration.