Subtalar Staple Arthroereisis For Planovalgus Foot Deformity In Children With Neuromuscular Disease

Objective: A retrospective analysis transfixation of the Subtalar Staple Arthroereisis in treatment of children with cerebral palsy of Plano-valgus Foot.The clinical effect and image correction to be evaluated and discussed.Methods:Cases of clinical data collected from patients with PPV in 2010 to 2014 during the Hunan Province Children's Hospital,Clinical and radiolog-ical performance of the patients were regularly followed and the complete data were compared and analyzed.Radiological evaluation inclulded:On the weight-bearing dorsoplantar view X-ray:Talus-calcaneus Angle,Talus-long-itudinal axes of the first metatarsals Angle.On the lateral view X-ray : Talu-s-calcaneus Angle,calcaneal pitch Angle,Talus-horizontal Angle,Talus-lon-gitudinal axes of the first metatarsals Angle.Clinical evaluated:Maryland foot score were used in the assessment of foot function and pre-operative and post-operative.Postoperative follow-up imaging and clinical data were comp-ared for Subtalar Staple Arthroereisis.Data was recorded by Microsoft Ex-cel,SPSS 18 statistical software for data analysis.The data were normality and homogeneity of variance test,if eligible,the data represented by x ± s,measurement data using t-test;If do not accord with normal distribution and homogeneity of variance,using the Mann-Whitney U test.Count data using rank sum test,the difference was statistically significant(p <0.05).Results: from 2010 to June 2014,19 cases(28 feet)in 15 cases(21 feet)to complete the follow-up after surgery,including 4 cases(8 feet)due to posto-perative follow-up from June lost in this experiment,9 male cases(13 feet)and 6 females(8 feet),the average follow-up time(34.47±1.77)months(range from 34 months to36 months).(1)Compared with preoperative and postopera-tion angles,On the weight-bearing dorsoplantar view X-ray:Talus-calcaneus Angle:[(46.72±2.47)°VS(11.05±1.48)°,(p <0.05)],Talus-longitudinal axes of the first metatarsals Angle:[(18.52±1.75)°VS(5.94±1.88)°,(p <0.05].On the lateral view X-ray:Talus-calcaneus Angle: [(52.25±1.59)°VS(36.22 ± 4.29)°,(p <0.05)],calcaneal pitch Angle:[(3.76±0.89)°VS(12.24±2.20),(p<0.05)],Talus-horizontal Angle:[(38.43±2.43)°VS(10.15±2.20)°,(p <0.05)],Talus-longitudinal axes of the first metatarsals Angle:[(23.68±2.53)° VS(8.27±1.94),(p <0.05)].according to a =0.05,p <0.05,there is statistic-al significance.(2)Clinical evaluation by American foot and ankle surgery Maryland Foot Score,count data using rank sum test,t =-3.56(p < 0.001),according to a =0.05,there was statistical significance,There were signifi =cant differences in the clinical efficacy of the Subtalar Staple Arthroereisis after the operation.Conclusions: The Subtalar Staple Arthroereisis in treatment of children with cerebral palsy of flat foot valgus can effectively correct the abnormal structure and interfere with the progression of foot deformity,with simple operation,safety,less complications,but the procedure in the domestic and foreign research data is too small,the operation result is unpredictable,but also need further study.