Mou Xiaping,Ji Yong,Liao Wei,et al.Mid-term comparative study of lateral column lengthening and extraosseous talotarsal stabilization for the treatment of flexible flatfoot in children[J].Journal of Clinical Pediatric Surgery,,21():63-68.[doi:10.3760/cma.j.cn.101785-202101049-012]
Mid-term comparative study of lateral column lengthening and extraosseous talotarsal stabilization for the treatment of flexible flatfoot in children
- Keywords:
- Flexible Flatfoot/SU; Lateral Column Lengthening; Extraosseous Talotarsal Stabilization; Treatment Outcome; Follow-Up Studies; Child
- Abstract:
- Objective To compare the mid-term effects of lateral column lengthening (LCL) and extraosseous talotarsal stabilization (EOTTS) in treating children with flexible flatfoot. Methods A retrospective review was led on 33 pediatric patients (38 feet) with flexible flatfoot from June 2012 to June 2016.Patients were divided into two groups.The LCL group:19 cases (22 feet) including 12 males, 7 females, with the mean age 9.5±2.3 years.The EOTTS group:14 cases (16 feet) including 9 males and 5 females with the mean age 10.2±2.1 years.Anteroposterior X ray of talar-to-first metatarsal angle (T1MT), talar-to-second metatarsal angle (T2MT) talonavicular coverage angle (TCA), calcaneal pitch angle (Pitch angle) and talo-calcaneal angle (Kite angle) were measured.The visual analogue scale (VAS) score, Maryland score, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, Viladot’s grading of flatfoot on footprint were compared before operation and at the final follow-up between the two groups. Results The mean follow-up of LCL and EOTTS groups were (44.4±2.2)(36-66) months and (47.5±1.7)(38-74) months respectively.Significant inter-group differences in operation time, intraoperative blood loss, length of incision and length of stay were noted (P<0.05).There were two patients in LCL group and one patient in EOTTS had complications, with no statistical differences (χ2=0.0972, P>0.05).The angles of T1MT, T2MT, TCA, Meary, Pitch and Kite were significantly improved (P<0.05) at the last follow-up compared with those before the operation.VAS score and Viladot’s grading of flatfoot on footprint decreased (P<0.05), while Maryland score and AOFAS ankle and hindfoot score increased (P<0.05) at the final follow-up visit compared with those before operation in each group. Conclusion To apply LCL in treating children with flexible foot has the same effect as EOTTS.Both approaches can obtain a satisfactory outcome in the mid-term, yet the latter is superior with shorter operation time, small trauma, less bleeding and shorter length of stay, which is an ideal minimally invasive technique.However, additional operations should be considered to strengthen the therapeutic effect based on patient’s etiology, clinical symptom and imaging evaluation.
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Memo
收稿日期:2022-02-13。
通讯作者:唐康来,Email:tangkanglai@hotmail.com