Abstract
Pronatus syndromes of the hindfoot often represent a deformity in patients of developing age. They are characterised by internal valgus rotation and adduction of astragalus, calcaneous pronation and valgus tibial-calcaneous axis. During the walking phase, the astragalic leaning phase is increased with a consequence of wider pronation of the forefoot. This often creates a functional compensation of the joint and of the myotendinous structures of IMF and progressive valgus deviation of the hallux.
In the last few years, many different techniques to correct and to stabilise the altered alstagalus-calcaneous relation have been introduced. This altered relation represents the ‘primum movens’ of this deformity through the stimulation of the endotarsal proprioreceptors; this evokes some inputs that allows the capsular ligaments a retraction structure during the development.
In the period between April 2001 and December 2003, in the 1st Clinica Ortopedica of the Bari University, 30 patients (16 males and 14 females; age range between 7–12 years, median age 9.6 years) with pronatus syndrome were treated with surgical astragalus-calcaneous arthrorisis according to Pisani; 27 patients were operated bilaterally. All patients (57 feet) were evaluated at a median follow-up of 15.3 months (range 2–32 months). Clinical and radiological results have shown alignment of the hind-foot and normal plantar part of the foot.
These data confirms that the astragalus-calcaneous arthrorisis represents a valid technique in the pronatus syndrome.
