Correlation between long-term efficacy of subtalar joint immobilization surgery for adolescents with flexible flatfoot and the ligament relaxation score
Objective:To evaluate the correlation between the long-term efficacy of subtalar joint immobilization surgery for adolescents with flexible flatfoot and the ligament relaxation score.Methods:A retrospective analysis was performed on 74 adolescents with flexible flatfoot who underwent subtalar joint immobilization surgery from January 2016 to June 2018.Patients were divided into two groups based on the Beighton score for assessing ligament relaxation:a ligament relaxation group with a score of ≥4(40 cases)and a non-ligament relaxation group with a score of＜4(34 cases).The correlations between the Beighton score and final follow-up efficacy indicators[visual analogue scale(VAS),foot and ankle ability measure(FAAM),talus-navicular coverage angle,talus-first metatarsal angle,talus-second metatarsal angle,Meary angle,and calcaneal inclination angle]were evaluated.Results:The 74 patients were followed up for 54 to 65 months,with an average follow-up of 59 months.At the last follow-up,the patients in the non-ligament relaxation group demonstrated significantly better postoperative efficacy scores(VAS,FAAM,talus-navicular coverage angle,talus-first metatarsal angle,talus-second metatarsal angle,Meary angle,and calcaneal inclination angle)compared to the ligament relaxation group(all P＜0.001).There was a correlation between the Beighton score and surgical efficacy indicators in the ligament relaxation group,while there was no correlation in the non-ligament relaxation group.Conclusions:For adolescents with flexible flatfoot,when the Beighton score is ≥4 indicating ligament relaxation,the long-term efficacy of subtalar joint immobilization surgery is negatively correlated with the Beighton score,and the efficacy is inferior to those in the non-ligament relaxation group(Beighton score＜4).Ligament relaxation should be assessed preoperatively in adolescents with flexible flatfoot,and subtalar joint immobilization should be carefully considered for patients with ligament relaxation.
Adolescents with Flexible FlatfootSubtalar Joint Immobilization SurgeryLigament Relaxation
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