Surgical treatment of flexible flatfoot in adolescents: Sinotarsic endorthesis

Objectives: The surgical procedure of arthroereisis for flexible flatfoot involves placing a screw or spacer between the talus and calcaneus, limiting the excessive inclination of the calcaneus. This study aimed to evaluate the clinical results of patients treated using an endosenotarsal screw. Methods: Seventy-three patients were treated with arthroereisis (54 unilateral and 19 bilateral) using the Fit-As subtalar screw (Gemes ® ). A total of 92 screws were implanted. Pre- and post-operative clinical evaluations were performed before and 3 months after the operation. Results: The median follow-up period was 46 months (12–80 months). The average age at the time of surgery was 12 years (range 8–19 years). The mean pre-operative American Orthopedic Foot and Ankle Society (AOFAS) score was 63.7/100, while the mean post-operative AOFAS score was 98.6/100. The average pre-operative disability index Foot and Ankle Disability Index Questionnaire was 77.7/104, whereas the average post-operative index was 102.3/104. None of the treated patients required surgical screw removal at the time of the final follow-up. Conclusion: The results obtained in this series of patients with Fit-As titanium endorthesis are in accord with those reported in the literature and lead to good clinical results, the absence of complications, and the unnecessary removal of the device.