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    Long-Term Outcomes of the Calcaneo-Stop Procedure in the Treatment of Flexible Flatfoot in Children: A Retrospective Study.
    Acta Med Port 2017 Aug 31;30(7-8):541-545. Epub 2017 Aug 31.
    Unidade de Ortopedia e Traumatologia. Departamento de Cirurgia. Faculdade de Medicina. Universidade do Porto. Porto. Portugal; Departamento de Ortopedia e Traumatologia. Centro Hospitalar de São João. Porto. Portugal.
    Introduction: Flexible flatfoot is common amongst children, although treatment is rarely indicated. The calcaneo-stop procedure has been reported to be effective in short-term studies. We aim to evaluate the long-term outcomes of the calcaneo-stop procedure in the treatment of flexible flatfoot in children.

    Material And Methods: Twenty-six calcaneo-stop procedures performed between 1995 and 2006 on 13 patients were evaluated clinically and using photopodoscopy, and the FAOS questionnaire was applied for both feet.

    Results: Of the 26 feet evaluated, 22 presented with heel valgus, 13 had forefoot supination and 11 had abnormal footprints. Median FAOS questionnaire score was 97.22 for 'Pain', 92.86 for 'Other symptoms', 98.53 for 'Function in daily living', 100 for 'Function in sports and recreation' and 93.75 for 'Foot and ankle-related quality of life'.

    Discussion: The calcaneo-stop procedure is the least invasive and most simple surgical treatment for symptomatic flexible flatfoot in children. Short-term studies report excellent clinical and radiographic results. The authors report alterations in clinical parameters in a large proportion of patients. These findings can be due to biomechanical alterations in the years following removal of the screw. Patient foot and ankle-related satisfaction data is promising, although hard to evaluate given the absence of preoperative data.

    Conclusion: Larger, prospective, controlled studies are required to better evaluate the long-term success of this procedure.

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    Orthopaedic Clinic, University of Catania, Azienda Ospedaliera Universitaria, Policlinico Vittorio Emanuele, Catania, Italy.
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    Department of Orthopaedic Surgery, Azienda Ospedaliera Universitaria Integrata, Polo Chirurgico P. Confortini, Verona, Italy.
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