Calcaneostop Provides Favorable Short-term Outcomes in Patients With Flexible Flatfoot.

Abstract

Background: Flatfoot is a relatively frequent deformity seen in almost 5% of children. It is classified into flexible and rigid flatfoot. Symptomatic flexible flatfoot (FFF) can be managed using several procedures, and calcaneostop is one of the procedures that has gained popularity recently. This study aimed to evaluate the outcome of the calcaneostop procedure using screws. Methods: We retrospectively evaluated 57 feet in 44 consecutive patients with FFF undergoing calcaneostop surgery. The same pediatric orthopedic surgeon performed all surgeries. Following a 10-mm incision on the sinus tarsi, a partial thread 6.5 cancellous screw size 40 was inserted. Achilles tendon lengthening was performed on all patients, and a short leg cast was applied. Pain relief, complications, and the change in the talocalcaneal (Kite), talometatarsal (Meary’s), and calcaneal inclination (Pitch) angles were evaluated on plain radiographs using a paired t test. Results: Pain relief was achieved in 55 (96.5%) cases, and 2 (3.5%) patients experienced pain after surgery. Other complications, including nerve damage, infection, screw loosening, fracture, or position loss, were not observed. The mean preoperative and postoperative Meary’s, Kite, and Pitch angles were 15.74 ± 2.02 (12.30-21.60), 8.72 ± 1.03 (7.20-10.60), 31.23 ± 1.97 (27.80-37.30), 21.30 ± 1.98 (18.50-24.60), 12.40 ± 1.64 (8.50-16.60), and 18.52 ± 1.97 (15.90-22.60), respectively. A significant improvement was observed in each angle following surgery (p<0.001). Conclusion: Calcaneostop is an inexpensive and simple procedure that avoids the involvement of several joints and uses a simple incision leaving a small scar. This procedure is remarkably successful and can be quite convenient.