Journal List > J Korean Foot Ankle Soc > v.19(4) > 1043358

J Korean Foot Ankle Soc. 2015 Dec;19(4):176-180. Korean.
Published online December 09, 2015.
Copyright © 2015 The Korean Foot and Ankle Society. All rights reserved.
Calcaneo-stop Procedure for Management of Pediatric Symptomatic Flexible Flatfoot
Kang Lee, and Young Joon Nam
Department of Orthopaedic Surgery, Kangwon National University School of Medicine, Chuncheon, Korea.

Corresponding Author: Kang Lee. Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon 24289, Korea. Tel: 82-33-258-2308, Fax: 82-33-258-2149, Email:
Received October 20, 2015; Revised November 11, 2015; Accepted November 11, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



The aim of the current study is to report on the clinical and radiographic results after calcaneo-stop procedure in Korean children with symptomatic flexible flatfoot.

Materials and Methods

Twenty-two children suffering pain along the medial aspect of midfoot with flexible flatfoot whose symptoms did not improve with conservative measures and therefore underwent calcaneo-stop procedure were identified retrospectively. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analogue scale (VAS) were evaluated. Radiographically, standing anteroposterior and lateral radiographs of the foot and Saltzman's alignment views were taken and talonavicular coverage angle, lateral talo-first metatarsal angle, and hindfoot alignment angles were measured and analyzed.


Clinically, AOFAS ankle-hindfoot scale improved from 70.3±5.6 to 97.3±2.5 and VAS improved from 6.4±1.6 to 0.2±0.4. Radiographically, talonavicular coverage angle improved from 28.3°±12.3° to 10.9°±8.1°, lateral talo-first metatarsal angle improved from -19.3°±9.0° to -2.4°±8.1°, and hindfoot alignment angle improved from valgus 11.9°±10.0° to 3.5°±4.3° at minimum 2-year follow-up. No complications occurred postoperatively.


Calcaneo-stop procedure is a simple and very effective procedure for management of pediatric symptomatic flexible flatfoot that does not respond to conservative treatment.

Keywords: Flatfoot; Pediatric; Arthroereisis; Calcaneo-stop


Figure 1
(A) Preoperative weight-bearing anteroposterior radiograph of 11-year-old boy shows abnormal talonavicular coverage angle of 28°. (B) Preoperative weight-bearing lateral radiograph shows decreased lateral talo-first metatarsal angle of -26°. (C) Preoperative Saltzman's alignment view shows heel alignment angle of valgus 25°.
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Figure 2
Calcaneo-stop procedure was performed and postoperative radiograph was taken at 2-year follow-up. (A) Weight-bearing anteroposterior radiograph shows normal talonavicular coverage angle of 7°. (B) Weight-bearing lateral radiograph shows improved lateral talo-first metatarsal angle of 1°. (C) Saltzman's alignment view shows heel alignment angle of valgus 4°.
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Table 1
Radiographic and Clinical Results of Children with Calcaneo-Stop Procedure
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