Abstract
In this retrospective study, we aim to assess the safety and feasibility of adapting subtalar arthroereisis (SA) for type I osteogenesis imperfecta (OI) patients with symptomatic flatfoot. From December 2013 to January 2018, six type I OI patients (five girls and one boy, 12 feet) with symptomatic flexible flatfoot were treated with SA and the Vulpius procedure. All the patients were ambulatory and skeletally immature with failed conservative treatment and unsatisfactory life quality. The median age at the time of surgery was 10 years (range 5–11), and the median follow-up period was 55 months (range 33–83). All functional and radiographic parameters improved (p < 0.05) after the procedure at the latest follow-up. The median American Orthopaedic Foot and Ankle Society ankle-hindfoot scale improved from 68 (range 38–80) to 95 (range 71–97). All of the patients ambulated well without significant complications. The weight-bearing radiographs showed maintained correction of the tarsal bone alignment with intact bony surfaces adjacent to implants during the post-operative follow-up period. This is the very first study on symptomatic flatfoot in pediatric patients with type I OI. Our data suggest that SA is a potentially viable approach, as functional improvements and maintained radiographic correction without significant complication were observed.
Highlights
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.license.Osteogenesis imperfecta (OI) is a rare, hereditary, heterogeneous connective tissue disorder characterized by extreme bone fragility and soft tissue defect, with a prevalence of 3–7 per 100,000 births [1]
osteogenesis imperfecta (OI) paOrthopedic areare cautious in performing operative management on OIon patients tients because of the nature of the disease, which is true when dealing with symptobecause of the nature of the disease, which is true when dealing with symptomatic matic flexible in OI patients
Considering the reduced osteochondral damage and faster recovery along with early full weight-bearing, subtalar arthroereisis (SA) seems to be appropriate for OI patients
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.license (https://creativecommons.org/licenses/by/4.0/).Osteogenesis imperfecta (OI) is a rare, hereditary, heterogeneous connective tissue disorder characterized by extreme bone fragility and soft tissue defect, with a prevalence of 3–7 per 100,000 births [1]. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Secondary to ligamentous laxity and joint hypermobility, the nature of the disease makes flatfoot an common deformity, reported in 24–75% of OI patients [2]. The prevalence of flatfeet is reported to be around 20–24% in the general population [3]. Limited study of the epidemiology of flatfoot deformity in different genome types has been reported. The natural history of flatfoot in Sillence type I patients, the milder form of OI, has not been well documented in the literature, severe cases were noted in our institute (Figure 1). A 52-year-old woman with Sillence type I OI complained of pain and deformity of her bilateral hindfeet
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