[The talus stop screw arthroereisis for flexible juvenile pes planovalgus].

OBJECTIVE

Pain relief by realignment of the hindfoot and blocking excessive pronation through insertion of a screw into the lateral aspect of the calcaneus in juvenile pes planovalgus.

INDICATIONS: Symptomatic juvenile flatfoot (9-13 years).

CONTRAINDICATIONS: Congenital, fixed and secondary (neuromuscular disorder) flatfoot deformities.

SURGICAL TECHNIQUE: Incision at the lateral aspect of the sinus tarsi. Guide wire insertion into the lowest point of the lateral anterior calcaneus (fluoroscopy). Drilling (3.2 mm) and insertion of a 6.5-7.0 mm cancellous screw. The screw head impinges against the lateral aspect of the talus and prevents excessive eversion.

POSTOPERATIVE MANAGEMENT: Compression dressing. Full weight bearing allowed. No sports activity for 4 weeks.

RESULTS

Between 2002 and 2011, the technique was used in 35 children (68 feet; mean age 10 years). Complications were peroneal spasms, overcorrections, wound healing problems and local tenderness. Tarsometatarsal and calcaneal pitch angle improved significantly. The procedure is a reliable method for the correction of flexible juvenile flatfeet allowing "growth adjustment" of the subtalar joint.