Subtalar joint narthroereisis for the treatment of flexible flatfoot in children: a comparative efficacy study based on chronological age and bone age stratification
Year: 2026
Type: article
Abstract: Objective To investigate subtalar joint arthroereisis efficacy for pediatric flexible flatfoot and analyze how chronological and bone age at surgery influence mid-term outcomes. Methods A retrospective cohort study included 92 children who received subtalar joint arthroereisis at our hospital between January 2012 and December 2020 (surgical age 6–15 years). Eleven children were lost to follow-up, and 81 patients with complete datasets entered final analysis. Patients were stratified by chronological age (Group A: 6–8 years; Group B: 9–12 years; Group C: 13–15 years) and by bone age determined via the Greulich-Pyle method. VAS, AOFAS score, and radiographic parameters (T1MT, T2MT, TCA, Meary's angle, calcaneal pitch, Kite's angle) were compared pre-operatively, 6 months post-operatively, and at final follow-up. Results At 6 months after surgery and the final follow-up, the VAS scores, AOFAS scores, and all imaging angles of the three groups were significantly improved compared with those before surgery ( P < 0.001). At the final follow-up, the scores and imaging angles of Group A and Group C decreased compared with those at 6 months after surgery, with statistically significant differences ( P < 0.0001). Only Group B maintained stable indicators, with no statistically significant difference between the results at 6 months after surgery and the final follow-up ( P > 0.05). Further analysis of bone age stratification confirmed that children aged 9–12 years had a greater reduction in VAS scores, a greater increase in AOFAS scores, and better corrective effects on imaging angles than those in other age groups, with the highest stability of long-term efficacy. Conclusion Within this cohort, children aged 9-12 years had the most stable mid-term outcomes after subtalar arthroereisis. Bone age acts as a valuable complementary reference for individualized surgical-timing decisions. Children aged 6-8 or 13-15 years had acceptable short-term effects but risk mid-term deterioration, requiring intensified long-term follow-up. Further large prospective multicenter studies are needed to validate these findings.
Source: Frontiers in Surgery
Authors: Xiangqian Ji, Xinhe Chen
Institutions: Fifth Hospital of Shijiazhuang, Hospital of Hebei Province
Language: English
Topic: Foot and Ankle Surgery
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7225777818