1.Subtalar Arthroereisis as a Reliable Option for Flexible Flatfoot in Children – A Case Series
Miraj F ; Karda IWAM ; Noor EA
Malaysian Orthopaedic Journal 2025;19(No. 3):42-52
Introduction: Conservative treatment in flexible flat foot
(FFF) is preferred in most cases; only in symptomatic and
conservative-refractory cases is surgical treatment proposed.
Subtalar arthroereisis (STA) is a well-established technique,
but there remains a paucity of information surrounding the
effectiveness and outcome. The aim of this study was to
evaluate radiological and functional outcome of STA in FFF.
Materials and methods: This study is a case series of 15ft
with symptomatic FFF treated by STA from a period of
2018-2024. Mean age at the time of surgery was 10.1±0.83
years. There was a significant increase in both American
Orthopaedic Foot and Ankle Society score (AOFAS) and
The Oxford Ankle Foot Questionnaire for Children
(OxAFQ-C) subjective scoring with p-value of <0.001.
Degree of valgus correction was statistically significant
(p=0.001). There were significant differences between preand post-operative lateral radiographic measurements with
p-value of <0.005. One patient with the lowest radiological
angle of correction and increased femoral anteversion had
loosened implant in two years follow-up.
Results: Despite results in earlier studies, recent evidence,
including randomised control trials, supports the reliability
of STA in managing FFF, advocating its use over traditional
osteotomies due to fewer complications and quicker
rehabilitation periods. In our study, all subjects had
significant improvement in lateral radiographic
measurements and subjective scoring evaluation during
follow-up.
Conclusion: STA is an option for surgical treatment in
symptomatic FFF patients. In this study, all presented
subjects showed overall satisfying functional and
radiological outcome.


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