Hi Kevin I remember not that long ago a time when it was considered controversial to suggest any intervention in paediatric flatfoot, never mind whether it was symptomatic or not. How times have changed. These days, when I see a severely flat footed child we not only discuss orthotic management but also subtalor artheroesis.
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Pros and Cons of the Subtalar Joint Arthroereisis Procedure in Pediatric Flatfoot Deformity