{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:06:16Z","timestamp":1783746376015,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T00:00:00Z","timestamp":1490832000000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81601878"],"award-info":[{"award-number":["81601878"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the therapeutic outcomes with Kalix<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>subtalar arthroereisis in sinus tarsi for juvenile flexible flatfoot.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of the data of 20 juveniles with symptomatic flexible flatfoot (27 feet) who underwent the Kalix<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>implant procedure from January 2008 to September 2012 was performed. The pain during daily activities was assessed and followed up by use of a standard 10\u2010point visual analog scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>), and function was evaluated using the American Orthopaedic Foot and Ankle Society (<jats:styled-content style=\"fixed-case\">AOFAS<\/jats:styled-content>) ankle and hindfoot scoring system, and anteroposterior talar\u2010first metatarsal angle, lateral talar\u2010first metatarsal angle, calcaneal pitch angle, and talar declination angle at X\u2010ray film were measured to assess the therapeutic outcomes. Patients were asked to grade the result of the procedure as excellent, good, fair, or poor at latest follow\u2010up. The data was expressed as mean \u00b1 standard deviation (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>). A paired Student's<jats:italic><jats:styled-content>t<\/jats:styled-content><\/jats:italic>\u2010test was used for comparisons of the preoperative and postoperative angular measurements for each foot,<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>scores, and<jats:styled-content style=\"fixed-case\">AOFAS<\/jats:styled-content>scores. In all tests,<jats:italic>P<\/jats:italic>&lt; 0.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the patients was 12.1 years (range, 7\u201316 years), and 16 left feet and 11 right feet were involved. All patients finished the follow\u2010up with a mean period of 28.1 months (range, 23\u201360 months). Eleven feet were treated with subtalar arthroereisis combined with reconstruction of the end point of the posterior tibialis tendon after dissection of the accessory scaphoid. The subtalar arthroereisis device displaced in 1 foot due to a fall from the inversion position 3 months after surgery, and was replaced by a new device after the failure of conservative treatment. The mean<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>score decreased from 5.6 \u00b1 0.5 preoperatively to 1.2 \u00b1 0.2 (<jats:italic>P<\/jats:italic>&lt; 0.001), and the mean<jats:styled-content style=\"fixed-case\">AOFAS<\/jats:styled-content>hindfoot and ankle score improved from 71.1 \u00b1 6.1 preoperatively to 88.1 \u00b1 6.3 (<jats:italic>P<\/jats:italic>&lt; 0.001). Differences between preoperative and postoperative measurements for each radiographic variable were statistically significant (<jats:italic>P<\/jats:italic>&lt; 0.001). Comparison of radiographic measurements showed that the anteroposterior talar\u2010first metatarsal (Meary) angle decreased by a mean of 12.8\u00b0 \u00b1 1.5\u00b0, the lateral talar\u2010first metatarsal (Meary) angle decreased by a mean of 15.4\u00b0 \u00b1 1.3\u00b0, the calcaneal pitch angle increased by a mean of \u22122.1\u00b0 \u00b1 0.7\u00b0, and the talar declination angle decreased by a mean of 17.9\u00b0 \u00b1 2.8\u00b0. Overall, 12 patients rated the result as excellent, 6 as good, and 2 as fair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The application of Kalix<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>in subtalar arthroereisis combined with dissection of accessory scaphoid and reconstruction of posterior tibialis tendon is an effective therapy for flexible juvenile flatfoot.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12309","type":"journal-article","created":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T22:57:41Z","timestamp":1490914661000},"page":"20-27","source":"Crossref","is-referenced-by-count":20,"title":["Therapeutic Outcomes of Kalix<scp>II<\/scp>in Treating Juvenile Flexible Flatfoot"],"prefix":"10.1111","volume":"9","author":[{"given":"Le","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu\u2010dong","family":"Miao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010ping","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang\u2010feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Affiliated Hospital Zhejiang University School 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