Der Orthopäde
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Ankle fractures are the most frequent factures of weight-bearing joints in children while fractures of the hindfoot and midfoot are rare. Metatarsal fractures make up the greatest portion of foot fractures in children and mostly heal uneventfully. ⋯ Computed tomography scanning is most useful to precisely evaluate the degree of injury, especially articular involvement and to allow precise planning of the operative approach. Except for the calcaneus and the metatarsals the bones of the foot and ankle do not display a significant potential for spontaneous correction during growth; therefore, open reduction and internal fixation is indicated in all displaced fractures if closed reduction does not yield a satisfying result in order to avoid relevant post-traumatic deformities.
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The minimally invasive subtalar screw arthroereisis procedure is becoming an increasingly more established option for treating juvenile flexible flatfoot. The procedure is indicated in children who are 9-13 years old and have idiopathic juvenile flexible flatfoot that has progressed to a symptomatic pathology. ⋯ This surgical intervention is contraindicated for treating fixed and secondary pes plano valgus. The subtalar screw is removed once the pediatric foot has stopped growing and results in permanent correction of the flexible flatfoot.