Efficacy of local steroid injection in the treatment of idiopathic spasmodic flatfoot in pediatric and adolescent patients

Khaled, Mohamed; Hafez, Abdelkhleak; Hassanein, Mohamed Y.; Phillip, Pemen; Oyoun, Nariman Abol

doi:10.4103/eoj.eoj_36_24

Efficacy of local steroid injection in the treatment of idiopathic spasmodic flatfoot in pediatric and adolescent patients

Authors

Abstract

Background and aim
Flatfoot deformity is one of the most prevalent foot issues among juvenile and adolescent patients. Patients with the spasmodic variety typically exhibit anomalies in their gait, recent changes in foot shape, and discomfort and stiffness in the foot and ankle. The current work aimed to evaluate the functional and clinical outcome of pediatric and adolescent patients with spasmodic flatfeet without coalition following long-acting steroid injection in the sinus tarsi and cast therapy.
Patients and methods
A prospective case series study was carried out at a tertiary care facility. A total of 20 patients were enrolled. All patients were diagnosed through clinical history, physical examination, and imaging including radiographs and magnetic resonance imaging (MRI) to exclude coalitions, bony and cartilaginous. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle – hind-foot score was used to evaluate all patients before and after the procedure.
Results
The results revealed significant improvement in American Orthopedic Foot and Ankle Society as regards comparison between baseline score (48.75 ± 6.01), score at 3 months (90.55 ± 3.26), 6 months (84.45 ± 3.23), and 12 months (83.15 ± 4.05) after the procedure. Also, there were significant improvements in Meary’s angle (38.60 ± 3.05 vs. 14.50 ± 5.08), Talonavicular coverage angle (16.20 ± 2.73 vs. 4.25 ± 1.92), and calcaneal pitch (8.85 ± 2.43 vs. 19.85 ± 3.29).
Conclusion
The procedure of local steroid injection, manipulation, and cast under general anesthesia has a significant role in the improvement of functional and radiological outcomes in adolescent idiopathic spasmodic flatfoot, with a remarkable role of MRI in obtaining a high success rate.

Keywords