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      Symptomatic flexible flatfoot in adults: subtalar arthroereisis

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          Flexible flatfoot is a common deformity in pediatric and adult populations. In this study, we aimed to evaluate the functional and radiographic results of subtalar arthroereisis in adult patients with symptomatic flexible flatfoot. We included 26 feet in 16 patients who underwent subtalar arthroereisis for symptomatic flexible flatfoot. Radiographic examination included calcaneal inclination angle, lateral talocalcaneal angle, Meary’s angle, anteroposterior talonavicular angle, and Kite’s angle. The clinical assessment was based on the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and a visual analog scale (VAS). The mean follow-up was 15.1±4.7 months. The mean preoperative AOFAS score was 53±6.6, while the mean AOFAS score at the last follow-up visit was 75±11.2 ( P<0.05). The mean visual analog scale score was 6.9±0.6 preoperatively and 4.1±1.4 at the last follow-up visit ( P<0.05). The mean preoperative and postoperative values measured were 13.4°±3.3° and 14.6°±2.7° for calcaneal inclination angles ( P<0.05); 35.7°±6.9° and 33.2°±5.3° for lateral talocalcaneal angles ( P>0.05); 8°±5.3° and 3.3±3 for Meary’s angles ( P<0.05); 5.6°±3.5° and 2.6°±1.5° for anteroposterior talonavicular angles ( P<0.05); and 23.7°±6.1° and 17.7°±5° for Kite’s angles, respectively ( P<0.05). Implants were removed in three feet (11.5%). Subtalar arthroereisis is a minimally invasive procedure that can be used in the surgical treatment of adults with symptomatic flexible flatfoot. This procedure provided radiological and functional recovery in our series of patients.

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          Most cited references 17

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          Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.

          Four rating systems were developed by the American Orthopaedic Foot and Ankle Society to provide a standard method of reporting clinical status of the ankle and foot. The systems incorporate both subjective and objective factors into numerical scales to describe function, alignment, and pain.
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            Measurement of pain.

            Pain is a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention, and other psychologic variables. Approaches to the measurement of pain include verbal and numeric self-rating scales, behavioral observation scales, and physiologic responses. The complex nature of the experience of pain suggests that measurements from these domains may not always show high concordance. Because pain is subjective, patients' self-reports provide the most valid measure of the experience. The VAS and the MPQ are probably the most frequently used self-rating instruments for the measurement of pain in clinical and research settings. The MPQ is designed to assess the multidimensional nature of pain experience and has been demonstrated to be a reliable, valid, and consistent measurement tool. A short-form MPQ is available for use in specific research settings when the time to obtain information from patients is limited and when more information than simply the intensity of pain is desired. The DDS was developed using sophisticated psychophysical techniques and was designed to measure separately the sensory and unpleasantness dimensions of pain. It has been shown to be a valid and reliable measurement of pain with ratio-scaling properties and has recently been used in a clinical setting. Behavioral approaches to the measurement of pain also provide valuable data. Further development and refinement of pain measurement techniques will lead to increasingly accurate tools with greater predictive powers.
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              Determining treatment of flatfeet in children.

              Infants are born with flexible flatfeet, and the normal arch develops in the first decade of life. Flexible flatfeet rarely cause disability, and asymptomatic children should not be burdened with orthotics or corrective shoes. Flexible flatfeet with tight heelcords may become symptomatic and can be addressed with a stretching program. Surgical intervention for flexible flatfeet is reserved for patients who have persistent localized symptoms despite conservative care. Rigid or pathologic flatfeet have multiple etiologies and many will require treatment to alleviate symptoms or improve function.

                Author and article information

                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                16 October 2015
                : 11
                : 1597-1602
                [1 ]Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey
                [2 ]Department of Orthopedics and Traumatology, Bayburt State Hospital, Bayburt, Turkey
                [3 ]Department of Orthopedics and Traumatology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
                Author notes
                Correspondence: Fırat Ozan, Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Sanayi Mahallesi, Atatürk Bulvari Hastane Caddesi, Kocasinan, 38010 Kayseri, Turkey, Email firatozan9@ 123456gmail.com
                © 2015 Ozan et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research


                pes planus, arthroereisis, sinus tarsi implant, flatfoot


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