Results of calcaneo stop arthroereisis in children with neuromotoric disorders

Aims: Hypotonic flatfeet is a common problem in patients with neuromotoric disorders. For treatment of flatfeet in normal developed children, the arthrorisis showed good results and was more often used in the last years in our hospital. For children with neuromotoric disorders, there are no clinical studies to confirm these good results for that population.

Methods: We included 11 Patients with neuromotoric disorders and 18 normal developed children with calcaneo stop arthrorisis with complete documentation pre- and postoperative X-rays and dynamic pedobarography. For the subjective changes of foot form, pain, and pressure sore we used a questionnaire with visual analogue scale. This questionnaire was answered by 9 Patients (18 feet) from the neuromotoric disorder group and 8 Patients (16 feet) of the normal developed group.

Results: Mean age at surgery was 12 years 7 month in the neuromotoric disorder group and 10 years 11 month in the normal developed group. There was significant improvement in both groups. In the neuromotoric group, pain was reduced from VAS 4.0 to VAS 0.7 (p < 0.05), pressure sore problem was reduced from VAS 2.3 to 0.3 (p < 0.05), Subjective foot form was improved from VAS 8.3 to VAS 2.8 (p < 0.001). In the normal developed group, pain was improved from VAS 4.8 to VAS 0.8 (p < 0.001), pressure sore problems were reduced from VAS 7.3 to VAS 0.01 (p < 0.05) and subjective foot form was improved from VAS 8.4 to VAS 1.6 (p < 0.001). The Talometatarsal basis I Winkel of Hamel could be improved from -48.3 ° to -26.7 ° (p < 0.05) in the neuromotoric group and from -38.8 ° to -25.5 ° (p < 0.001) in the normal developed group.

Conclusion: These results confirm that arthrorisis is a good treatment option for hypotonic flatfeet also in patients with neuromotoric disorders.