Treatment of flatfoot deformity with concurrent spinal disease in children

Objective To study the curative effect of operation to flatfoot deformity with concurrent spinal disease in children. Methods A retrospective survey was performed in 8 flatfoot patients with concurrent spinal disease from January 2004 to January 2008. Every case received special operative treatment. After casting, achilles tendon prolongation, reefing or tendon transfer, rehabilitation therapy was performed sequentially. Radiographs and clinical outcomes were evaluated during the follow-up. Results Six patients were followed up. There were 2 feet in 1 female and 7 feet in 5 males. The complications included tethered cord syndrome (n = 1 ), T12-S1 vertebral canal arachnoid cyst ( n = 1 ), cerebral palsy and scoliosis ( n = 1 ) and scoliosis and spinal bifada occult ( n = 3 ). The average age was 8.4 (4 - 14 ) years old and the average follow-up time 22 (14 -64) months. All cases were satisfied with the appearance and function according to Maryland foot score. Five were excellent, 2 good and 2 fair postoperatively versus 2 fair and 7 failed preoperatively. The total excellent and good rate was 77. 8%. In the early stage after tenden transfer in 4 patients, the lateral view of height arch, talus-first metatarsal angle, calcaneus navicular-first metatarsal angle and talonavicular coverage angle improved. Yet it lost the improved angle and reverted to the pre-operative state. No degenerative change was detected in tarsus joints during the long follow-up. Conclusion The special and sequential surgical procedure may be an effective regimen in the treatment of flatfoot deformity with concurrent spinal disease in children. Key words: Flatfoot;  Spinal diseases;  Surgical procedure, operative;  Child