Clinical Outcomes Following Treatment of Recurrent Talotarsal Joint Dislocation Using a Type II Extraosseous Talotarsal Stabilization Implant-A Long-Term Follow-Up Study.

Collapsing foot deformity (CFD) and its resulting sequelae caused by recurring talotarsal joint dislocation (RTTJD) affects pediatric and adult patients. An extraosseous talotarsal stabilization (EOTTS) procedure, a subset of subtalar arthroereisis (SA) procedures, is recommended as a minimally invasive, first in-line surgical treatment option for CFD. The aim of this multicenter, retrospective study was to evaluate patient-reported outcomes measures in patients who were treated for RTTJD with Type II EOTTS implants. Sixty-seven cases having a median age of 38 years (range: 10-74) with more than 5 years of follow-up were included in this study. The mean postoperative visual analog scale and Maryland Foot Score was 1.0 ± 1.9 and 92.3 ± 11.3, respectively, indicating excellent clinical outcomes. Subjectively, 88% cases reported as being satisfied with the outcome, 94% cases said they would recommend EOTTS, and 93% said that, if necessary, they would repeat it on their contralateral foot. A subgroup analysis revealed that while not statistically significant, clinical outcomes were slightly better in pediatric patients compared to adults. Implant removal rate was 4.5% (3 cases), and these were in the adult group only. Rate of minor issues such as pain, stiffness, discomfort, etc. was 15%; however, no serious adverse effects or complications were observed in any patient. This study suggests that EOTTS is an effective surgical treatment option wherein successful long-term clinical outcomes with low failure rates can be achieved in a select patient population.

Corrigendum: Pediatric Flatfeet-A Disease Entity That Demands Greater Attention and Treatment.

[This corrects the article DOI: 10.3389/fped.2020.00019.].

American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity.

This clinical consensus statement of the American College of Foot and Ankle Surgeons focuses on the highly debated subject of the management of adult flatfoot (AAFD). In developing this statement, the AAFD consensus statement panel attempted to address the most relevant issues facing the foot and ankle surgeon today, using the best evidence-based literature available. The panel created and researched 16 statements and generated opinions on the appropriateness of the statements. The results of the research on this topic and the opinions of the panel are presented here.

Pediatric Flatfeet-A Disease Entity That Demands Greater Attention and Treatment.

Background: Pediatric flatfoot is a common deformity. Unfortunately, the common opinion has been that most children with this faulty foot structure will simply out-grow it, despite no radiographic evidence to support this claim. Every step on a deformed foot leads to excessive tissue strain and further joint damage. Many forms of conservative and surgical treatments have been offered. This study was aimed at investigating the effectiveness of non-surgical and surgical treatment options. Main Text: faulty-foot structure is the leading cause of many secondary orthopedic deformities. A wide range of treatments for pediatric flatfeet have been recommended from the "do-nothing" approach, observation, to irreversible reconstructive surgery. Most forms of conservative care lack evidence of osseous realignment and stability. A conservative surgical option of extra-osseous talotarsal joint stabilization provides patients an effective form of treatment without the complications associated with other irreversible surgical procedures. Conclusion: Pediatric flatfeet should not be ignored or downplayed. The sooner effective treatment is prescribed, the less damage will occur to other parts of the body. When possible, a more conservative corrective procedure should be performed prior to irreversible, joint destructive options.

Extraosseous talotarsal stabilization using HyProCure®: preliminary clinical outcomes of a prospective case series.

The present multicenter, prospective study evaluated the subjective outcomes in patients after extraosseous talotarsal stabilization using the HyProCure(®) stent as a standalone procedure for the treatment of recurrent and/or partial talotarsal joint dislocation (RTTD) in a population of pediatric and adult patients. RTTD has been cited as a possible etiology for a number of foot ailments and might contribute to the development of pathologic features localized more proximally in the weightbearing musculoskeletal chain. Correction of RTTD might, therefore, lead to the reduction of pathologic features associated with this deformity. A total of 46 feet in 35 patients were included in the present investigation. Subjective evaluation used the Maryland Foot Score assessment, which was obtained preoperatively and 1, 2, and 3 weeks, 1, 2, 3, and 6 months, and 1 year postoperatively. The mean overall scores improved from a preoperative value of 69.53 ± 19.56 to a postoperative value of 89.17 ± 14.41 at the 1-year follow-up. Foot pain decreased by 36.97%, foot functional activities improved by 14.39%, and foot appearance improved by 29.49%. The greatest magnitude of improvement occurred 4 weeks postoperatively, with gradual improvement continuing through to the 1-year follow-up. Implants were removed from 2 patients (2 feet, 4.35%). No unresolved complications were observed. The positive subjective outcomes resulting from the extraosseous talotarsal stabilization procedure suggest that the intervention employing the device we have described alleviates pain and improves foot function and appearance in patients with RTTD.