• Lasse Hagen, Jonas Paul Pape, Mark Kostakev, and Christian-Dominik Peterlein.
• Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Baldingerstraße, 35043, Marburg, Germany. l.hagen.research@gmail.com.
• Arch Orthop Trauma Surg. 2020 Mar 1; 140 (3): 313-320.

BackgroundJuvenile flexible flatfoot deformity is a common problem in childhood. In severe cases, the subtalar extra-articular screw arthroereisis (SESA) according to De Pellegrin is a viable and effective option. There are just a few retrospective studies showing long-term outcomes, but the interval right after the surgery has not been described so far, even though the short time of healing is one of the great benefits of this technique. In this study, we examined if the pedobarographic measurements are able to demonstrate functional changes in the month after surgery.MethodsData were analyzed for seven patients (13 feet). Measurements were performed before surgery, as well as 3, 14 and 28 days after. For analysis, the foot was comparted in six areas-fore-, mid- and hindfoot, each split in their lateral and medial parts. Plantar forces and contact area were measured under static and dynamic conditions. Time-dependent changes of plantar acting forces and the contact area were compared.ResultsDuring bipedal stance, the ground force increased significantly in lateral foot areas (p < 0.001) and decreased in medial areas (p < 0.001). While the force in the medial midfoot remained reduced, in the medial forefoot, the force increased 14 days after surgery (p < 0.05) CONCLUSION: The functional changes after SESA can be accurately assessed using pedobarography. The results indicate morphologic changes of the foot, in particular the development of a longitudinal arch. Post-surgical progression can be monitored and success of the surgery can be verified.

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