Purpose: To review short-term results in 25 patients that underwent total ankle replacement with implantation of a second generation prosthesis.

Materials and methods: We reviewed 25 patients with ankle arthritis treated by total ankle replacement (TAR). Mean age of the patients was 58.2 years and mean follow-up 29.5 months. The cause of arthritis was posttraumatic in 17 cases. In all cases a HINTEGRA prosthesis was implanted. In 6 cases Achilles tendon lengthening was also performed. Review was carried out by anamnesis, clinical examination and radiological control. The ankle and hindfoot AOFAS scale was used to quantify clinical and functional results.

Results: Mean AOFAS score improved from 24.0 to 80.1 points. No significant differences were found between cases of traumatic and non-traumatic origin. Pain was the parameter with the best evolution. Mean ankle mobility went from 19° to 26°. Five cases required revision surgery: 2 ankle arthrodeses due to prosthetic loosening, 2 Achilles tendon lengthenings and one release of tibio-talar impingement. Prosthetic survival rate at 29.5 months’ follow-up was 92%. All patients, except for the 2 cases that required arthrodesis, were satisfied or very satisfied.

Conclusions: Total ankle replacement is an effective method for the treatment of ankle arthritis. Short term results are similar or better than those seen with arthrodesis.

Introduction: The hypothesis of this work is to demonstrate that the Flexible Flat Foot (FFF) in children is not affected for any kind of treatment. The objective is: 1.-Rate the evolution of FFF during growing. 2.- Evaluate the accuracy of diagnosis criterion. 3.-Appoint the optimal age to diagnose and treat the FFF. 4.- Evaluate the different kinds of treatment.

Material and methods: 242 children of both sex, aged between 3 and 5 years old, diagnosed of flexible flat foot. We compare three groups of treatment during three years. One group were treated with orthopaedic shoes and internal wedges, other with inserts, and the third were a control group. We evaluated: Clinical findings: age, sex, flat foot family antecedents, weight, degree of flat foot, valgus of ankle, age of begin to walk, ligament hiperlaxity, vicious direction of leg axis and erosion of shoes. Radiological measurements: An astragalus-1°metatarsian, Moreau and Costa-Bartani, and astragalus-calcaneus divergence angles, valgus of ankle according Viladot system. We perform a walking test with an electronic baropodometer “PEL 38” with 20 children of every group.

Results: An 85 % child of our series has been normalized with growing. The overweight and ligament hiper-laxity are the most predisponent family antecedents. The Jack Test is not a prognostic factor of FFF. The vicious direction of leg is not related with the FFF. The valgus of ankle is physiologic. X-ray are not reliable to diagnose a FFF in children, while the walking test give us dates about the dynamic behaviour of FFF.

Conclusions

– The flexible flat foot in children is normally corrected with growing and is a normal step of foot evolution.