[THE EFFECTIVENESS OF TREATMENT IN CHILDREN WITH RIGID FLATFEET AND DYSFUNCTION OF THE POSTERIOR TIBIAL TENDON]

Abstract

The rigid form of longitudinal flatfeet is one of the most common deformities of the foot in children. Dysfunction of the posterior tibial tendon is one of the causes of rigid foot formation with the development of pain syndrome, degenerative-dystrophic changes in the tarsal bones and joints. In most of these cases, conservative treatment is ineffective, prompting the use of surgical methods of foot correction - subtalar arthroereisis. However, currently, the indications for surgical treatment depending on the stage of posterior tibialis tendon dysfunction are poorly studied. The aim of the study was to analyze the clinical and radiological results of treatment of children with rigid flatfeet in the presence of posterior tibialis tendon dysfunction and to develop an algorithm of treatment depending on the stage of dysfunction. The results of treatment of 20 patients (40 cases) with the rigid form of longitudinal flatfeet during 12 months of follow-up were analyzed. In 18 patients (36 cases/90%) degenerative-dystrophic changes of the posterior tibial tendon according to Johnson and Strom classification were diagnosed. Conservative treatment with traditional methods was performed for 12 patients (24 cases), and 8 patients (16 cases) were operated on using subtalar arthroereisis. To analyze the results of treatment, clinical and radiological methods of investigation were performed. The use of conservative methods of treatment made it possible to obtain a positive result in patients with rigid flatfeet of the І severity degree and the absence of posterior tibialis tendon dysfunction. Subtalar arthroereisis was effective in children with II severity degree of rigid flatfeet and stage I of tendon dysfunction. Conservative treatment of rigid flatfeet is effective in the absence of posterior tibialis tendon dysfunction, and the use of subtalar arthroereisis is advisable in stage I of tendon dysfunction.