Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review

Dong Hun Suh, Jung-Ho Park, Soon-Hyuck Lee, Hak Jun Kim, Young Hwan Park, Woo Young Jang, Jung Heum Baek, Hyun Jae Sung, Gi Won Choi

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose: This systematic review aimed to compare radiographic correction, clinical outcomes, complications, and re-operations between lateral column lengthening (LCL) and arthroereisis (AR) for treating symptomatic flatfoot in children. Methods: We conducted a comprehensive search on MEDLINE, EMBASE, and Cochrane Library databases. Literature search, data extraction, and quality assessment were conducted by two independent reviewers. The outcomes analyzed included radiographic parameters, clinical scores, satisfaction, complications, and re-operations. Results: Twenty-one and 13 studies were included in the LCL and AR groups, respectively. The change in anteroposterior talo-first metatarsal angle was greater in the LCL (9.5° to 21.7°) than in the AR group (10.6° to 12.8°). The change in calcaneal pitch was greater in the LCL (2.1° to 26.53°) than in the AR group (− 1.3° to 3.23°). Improvements in the American Orthopedic Foot and Ankle Society (AOFAS) ankle–hindfoot score were greater in the LCL (27.7 to 39.1) than in the AR group (17 to 22). The percentage of satisfaction was similar between the LCL (68% to 89%) and AR (78.5% to 96.4%) groups. The complication rate was higher in the LCL (0% to 86.9%) than in the AR group (3.5% to 45%). The most common complications were calcaneocuboid subluxation and persistent pain in the LCL and AR groups, respectively. The re-operation rate was similar between the LCL (0% to 27.3%) and AR (0% to 36.4%) groups. Conclusions: The LCL group has achieved more radiographic corrections and more improvements in the AOFAS score than the AR group. Complications were more common in the LCL group than in the AR group, and the re-operation rates were similar between the two groups.

Original languageEnglish
Pages (from-to)1179-1192
Number of pages14
JournalInternational Orthopaedics
Volume43
Issue number5
DOIs
Publication statusPublished - 2019 May 2

Keywords

  • Calcaneal lengthening
  • Children
  • Flatfoot
  • Lateral column lengthening
  • Subtalar arthroereisis
  • Systematic review

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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