TY - JOUR AU - Smolle, Maria Anna AU - Svehlik, Martin AU - Regvar, Katharina AU - Leithner, Andreas AU - Kraus, Tanja PY - 2022/03/18 Y2 - 2024/03/28 TI - Long-term clinical and radiological outcomes following surgical treatment for symptomatic pediatric flexible flat feet: a systematic review JF - Acta Orthopaedica JA - ActaO VL - 93 IS - SE - Review, meta-analysis DO - 10.2340/17453674.2022.2254 UR - https://actaorthop.org/actao/article/view/2254 SP - 367–374 AB - <p><strong>Background and purpose:</strong> Albeit pediatric flexible flat foot (FFF) is a common condition, only a minority of patients become symptomatic. Long-term outcomes of surgically treated pediatric patients with symptomatic FFF are largely unknown. In this systematic review, studies providing outcomes at a mean follow-up of at least 4 years after the procedure in these patients were analyzed.</p><p><strong>Material and methods:</strong> A PubMed search was undertaken involving original articles published up to July 2021 on outcome in children aged 6 to 14 with surgically treated FFF and mean (or minimum) follow-up of at least 4 years. Radiographic and clinical outcomes were analyzed.</p><p><strong>Results:</strong> Of initially 541 entries, 10 could be included in the systematic review (all level IV), involving 846 pediatric patients with 1,536 symptomatic FFF. Pooled mean radiological (n = 8) and clinical follow-up (n = 10) was 5.3 (range 0.5–15) and 7.0 (range 4.1–15) years, respectively. Surgical procedures included arthroereisis (n = 8), lateral column lengthening (n = 1), and Horseman procedure (n = 1). Overall relative frequency of implant-associated complications and wound-healing problems was 3.2% and 1.3%, as well as 2.8% and 1.6% following subtalar arthroereisis only. From preoperative to latest radiological assessment following subtalar arthroereisis (including 3 studies with radiological follow-up &lt; 48 months), pooled median decrease in talonavicular coverage angle (TNCA; –9.2°), anteroposterior talocalcaneal angle (A-TCA; –6.5°), lateral talocalcaneal angle (L-TCA; –3.5°), talar declination angle (TDA; –14°),<br />Moreau Costa Bertani angle (MCB; –13°), and talo-firstmetatarsal angle (L-T1MA; –10°) was observed, as was an increase in calcaneal pitch (4.5°).</p><p><strong>Interpretation:</strong> In symptomatic pediatric FFF patients, surgery is associated with a manageable complication profile, and results in satisfactory long-term clinical as well as radiological outcome. Yet scientific evidence is low, warranting larger scaled studies in the future.</p> ER -