Surgical treatment of hallux valgus associated with flexible flatfoot during growing age

Cesare Faldini, Matteo Nanni, Francesco Traina, Daniele Fabbri, Raffaele Borghi, Sandro Giannini

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Methods: Thirty-two children (64 feet, age range 8–12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. Results: AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary’s angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. Conclusions: SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.

Original languageEnglish
JournalInternational Orthopaedics
DOIs
Publication statusAccepted/In press - Oct 27 2015

Fingerprint

Flatfoot
Hallux Valgus
Osteotomy
Metatarsal Bones
Growth
Absorbable Implants
Bone Wires
Therapeutics
Wound Healing
Skin

Keywords

  • Flatfoot
  • Growing age
  • Hallux valgus
  • SERI osteotomy
  • Subtalar arthroereisis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Surgical treatment of hallux valgus associated with flexible flatfoot during growing age. / Faldini, Cesare; Nanni, Matteo; Traina, Francesco; Fabbri, Daniele; Borghi, Raffaele; Giannini, Sandro.

In: International Orthopaedics, 27.10.2015.

Research output: Contribution to journalArticle

@article{a9a62ce11fe0477cbd2a3fba9625afa3,
title = "Surgical treatment of hallux valgus associated with flexible flatfoot during growing age",
abstract = "Purpose: During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Methods: Thirty-two children (64 feet, age range 8–12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. Results: AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary’s angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. Conclusions: SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.",
keywords = "Flatfoot, Growing age, Hallux valgus, SERI osteotomy, Subtalar arthroereisis",
author = "Cesare Faldini and Matteo Nanni and Francesco Traina and Daniele Fabbri and Raffaele Borghi and Sandro Giannini",
year = "2015",
month = "10",
day = "27",
doi = "10.1007/s00264-015-3019-9",
language = "English",
journal = "International Orthopaedics",
issn = "0341-2695",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Surgical treatment of hallux valgus associated with flexible flatfoot during growing age

AU - Faldini, Cesare

AU - Nanni, Matteo

AU - Traina, Francesco

AU - Fabbri, Daniele

AU - Borghi, Raffaele

AU - Giannini, Sandro

PY - 2015/10/27

Y1 - 2015/10/27

N2 - Purpose: During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Methods: Thirty-two children (64 feet, age range 8–12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. Results: AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary’s angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. Conclusions: SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.

AB - Purpose: During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. Methods: Thirty-two children (64 feet, age range 8–12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant. Clinical evaluation was summarized with AOFAS score, and standard standing radiographs were performed. Results: AOFAS score ranged from 86 ± 2 to 98 ± 2 (hindfoot) and from 80 ± 4 to 98 ± 2 (forefoot). HVA ranged from 21° ± 2 to 5° ± 2, IMA from 14° ± 2 to 7° ± 2, DMAA from 18° ± 2 to 2° ± 2, and Meary’s angle from 162° ± 11 to 175° ± 4. Complications included one case of delayed wound healing, inflammatory skin reaction around the outlet of the percutaneous Kirschner wire in two cases, displacement of the endorthotic implant in one case, and a second surgery to replace the implant. Conclusions: SERI osteotomy and subtalar arthroereisis resulted in an effective, technically simple and easily combined approach, with a high rate of good results and low rate of complications at mid-term follow-up. These techniques performed simultaneously represent a viable option in case of hallux valgus associated with flexible flatfoot during growth. Nevertheless, considering the limitations of this study, we believe that a larger case series and a longer follow-up should be desirable.

KW - Flatfoot

KW - Growing age

KW - Hallux valgus

KW - SERI osteotomy

KW - Subtalar arthroereisis

UR - http://www.scopus.com/inward/record.url?scp=84945292620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945292620&partnerID=8YFLogxK

U2 - 10.1007/s00264-015-3019-9

DO - 10.1007/s00264-015-3019-9

M3 - Article

AN - SCOPUS:84945292620

JO - International Orthopaedics

JF - International Orthopaedics

SN - 0341-2695

ER -