Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

This prospective study done on 50 cases (78 feet) of males and females (25 cases each) in age from 8 to 17 years old Median value: 12.5 (Mean 11.8 (SD 2.89)) for assessment of the results of surgical treatment of flexible flatfoot (FFF) by subtalar arthroereisis. We start to select patients from 8 years as this is the age child usually present after failed conservative measures for one or two years after expected arch to develop at age 5-6 years and study upper age limit is 17 years as no expected neuromuscular brain integration will develop sufficiently after this age. Cases of FFF in children presenting with pain and cosmetic disfigurement not responding to conservative management are exposed to modified subtalar arthroereisis using single cancellous screw 25-30 mm and 2-3 washers, Patients following specific post operative protocol and follow-up at certain periods. Those patients selected according to specific inclusion and exclusion criteria, patents were evaluated clinically and radiologically preoperative and post operative and also regarding pain , arch elevation , patient and parent satisfaction , functional outcome and complications. Pain evaluated by Visual Analog Scale for Pain and the functional outcomes are evaluated according to: the American College of Foot and Ankle Surgeons Scoring Scales preoperative and postoperative. Arch elevation evaluated by foot print method. Results of the current study shows improvement in clinical and radiolocical angles and improvement of clinical parameters when compared pre and post ABSTRACT 21 operatively. Results are comparable and even better in different aspects to other old methods using different implants to do same object of joint limitation. Few percent of complications occurred ( nearly 4%) and require no additional surgery. This study launch a new simple method of subtalar arthroereisis with low implant cost ,simple technique, short surgical time and easy post operative protocol comparable to other methods of subtalar arthroereisis. This study also prove that the correction is obvious in non operated foot in unilateral surgery by neuromuscular integration via proprioceptors in tarsal canal and this proved clinically and by measurement of radiological angles. This study is a multi center study done in collaboration of orthopaedic

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