Combined Calcaneo-Stop and Medial Displacement Calcaneal Osteotomy for Pediatric Flexible Flatfoot

Abstract

BackgroundFlatfoot is a common disorder characterized by a reduced or absent arch of the foot, typically seen in childhood. Surgical correction may be necessary for symptomatic cases. Calcaneo-Stop and medial displacement calcaneal osteotomy (MDCO) are surgical procedures used to correct the deformity, restore function, and avoid future problems. Precise patient selection and adherence to surgical protocols are essential to avoid complications. This study aims to assess the clinical and radiographic outcomes of using combined calcaneo-stop and MDCO in the treatment of pediatric flexible flatfoot.Patients and MethodsThis is a retrospective study that included 21 children, aged between 10 and 18 years old of both sexes diagnosed with flexible flatfoot (five bilateral cases). The study involved treating children with symptomatic flexible flat feet by combining two surgical methods: Calcaneo-Stop followed by MDCO. The study investigated the clinical and radiographic outcomes.ResultsAmerican orthopedic foot and ankle society score has significantly improved postoperatively, with a significant decrease in clinical heel valgus angle. The radiographic angles of the affected feet showed a statistically significant decrease in Meary’s angle in anteroposterior and lateral views, Costa-Bertani’s angle, talar declination angle, and a statistically significant increase in calcaneal pitch angle. The average hospitalization time was 2±1 days. The most common postoperative complication was local pain at incision in five (23.8%) patients and superficial infection in three (14.3%).ConclusionsCalcaneo-stop and MDCO combination effectively corrected radiographic angles and improved clinical outcomes in pediatric flexible flatfoot patients. While some minor complications occurred, the overall improvement in foot alignment, function, and patient-reported scores suggests that this method is a feasible choice for pediatric flatfoot deformity.