Objective:

To compare the clinical effectiveness of subtalar arthroereisis and osteotomy in treating symptomatic idiopathic flexible flatfoot in children, with a focus on both radiographic parameters and patient-reported outcome measures.

Key Findings:

• Subtalar arthroereisis is gaining popularity as a minimally invasive procedure with lower complication rates, suggesting a shift in treatment paradigms.
• Osteotomies remain a traditional surgical option but may involve higher complication rates and longer recovery, indicating a need for careful patient selection.
• Both procedures showed improvements in radiographic parameters and patient-reported outcomes, highlighting their effectiveness.

Interpretation:

The findings suggest that both subtalar arthroereisis and osteotomy can effectively treat symptomatic idiopathic flexible flatfoot in children, but further high-quality studies are needed to strengthen the evidence base.

Limitations:

• Variability in study designs and quality of evidence may affect the reliability of the findings.
• Limited number of studies directly comparing both interventions restricts comprehensive conclusions.
• Potential biases in patient selection and outcome reporting could influence the results.

Conclusion:

Both subtalar arthroereisis and osteotomy are viable surgical options for treating symptomatic idiopathic flexible flatfoot in children, with arthroereisis offering a less invasive alternative. However, further high-quality studies are needed to strengthen the evidence base.