{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:06:42Z","timestamp":1783746402619,"version":"3.55.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,12,25]],"date-time":"2019-12-25T00:00:00Z","timestamp":1577232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>Background. The purpose of this study is to evaluate functional and radiological outcomes of subtalar arthroereisis in the treatment of symptomatic pediatric flexible flatfeet. Methods. A total of 16 patients (26 feet) were treated with a Kalix II as subtalar motion blocker between 2009 and 2014. Calcaneal pitch (CP) and Meary\u2019s angle (MA) were measured on radiographs preoperatively, directly postoperatively, and at follow-up 47 \u00b1 17 (range 19-79) months. Patient satisfaction surveys were used to assess functional outcome and patient satisfaction. Results. Surgery was performed mostly for pain, walking problems, or a combination of both at a mean age of 12.5 \u00b1 1.5 (range 10-15) years. Symptoms were relieved in 62.5% of patients in the postoperative phase and increased to 68.75% at follow-up. A statistically significant increase in CP of 2.8\u00b0 and decrease in MA of 14.0\u00b0 was observed directly postoperatively, which persisted during the follow-up period irrespective of Kalix removal. Revision surgery was necessary in 6 cases (23%) because of arthroereisis migration. Conclusion. Subtalar Kalix II arthroereisis significantly reduced clinical symptoms and improved the CP and MA directly postoperatively, which persisted during follow-up, irrespective of Kalix removal. Therefore, subtalar arthroereisis is a considerable intervention to reduce symptoms in children with symptomatic flexible flatfeet.<\/jats:p>\n                  <jats:p>Levels of Evidence: Level IV: Case series<\/jats:p>","DOI":"10.1177\/1938640019892062","type":"journal-article","created":{"date-parts":[[2019,12,25]],"date-time":"2019-12-25T05:05:37Z","timestamp":1577250337000},"page":"9-18","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1085-4769","authenticated-orcid":false,"given":"Robin T. A. L.","family":"de Bot","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris P. S.","family":"Hermus","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heleen M.","family":"Staal","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lodewijk W.","family":"van Rhijn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adhiambo M.","family":"Witlox","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Maastricht University Medical Center, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,25]]},"reference":[{"key":"bibr1-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-009-1122-x"},{"key":"bibr2-1938640019892062","first-page":"247","volume":"23","author":"Halabchi F","year":"2013","journal-title":"Iran J Pediatr"},{"key":"bibr3-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200105000-00022"},{"key":"bibr4-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000039"},{"key":"bibr5-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5051.976"},{"key":"bibr6-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2126"},{"key":"bibr7-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.09.013"},{"key":"bibr8-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1230"},{"key":"bibr9-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpm.2009.08.004"},{"key":"bibr10-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-010-1380-7"},{"key":"bibr11-1938640019892062","first-page":"69","volume":"47","author":"Evans AM","year":"2011","journal-title":"Eur J Phys Rehabil Med"},{"key":"bibr12-1938640019892062","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S0891-8422(23)01143-6","volume":"17","author":"Roye DP","year":"2000","journal-title":"Clin Podiatr Med Surg"},{"issue":"7","key":"bibr13-1938640019892062","first-page":"CD006311","author":"Rome K","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr14-1938640019892062","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2011.1127"},{"key":"bibr15-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/107110070302400806"},{"key":"bibr16-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/1938640012470712"},{"key":"bibr17-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502600411"},{"key":"bibr18-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.10.019"},{"key":"bibr19-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602700103"},{"key":"bibr20-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.03.012"},{"key":"bibr21-1938640019892062","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S90649"},{"key":"bibr22-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-014-0619-7"},{"key":"bibr23-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/1938640010362262"},{"key":"bibr24-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2016.10.006"},{"key":"bibr25-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-010-0239-9"},{"key":"bibr26-1938640019892062","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870030-00013"},{"key":"bibr27-1938640019892062","first-page":"107","volume":"135","author":"Simons GW","year":"1978","journal-title":"Clin Orthop Relat Res"},{"key":"bibr28-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200103000-00018"},{"key":"bibr29-1938640019892062","first-page":"111","volume":"24","author":"Wijnen WMG","year":"2017","journal-title":"Ned Tijdschr Orthop"},{"key":"bibr30-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200101000-00010"},{"key":"bibr31-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0700-y"},{"key":"bibr32-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"bibr33-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1111\/os.12309"},{"key":"bibr34-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.53B1.96"},{"key":"bibr35-1938640019892062","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199504000-00002"},{"key":"bibr36-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3182648c74"},{"key":"bibr37-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000179"},{"key":"bibr38-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/1938640014548320"},{"key":"bibr39-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000449"},{"key":"bibr40-1938640019892062","doi-asserted-by":"publisher","DOI":"10.7547\/0990447"},{"key":"bibr41-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2018.12.002"},{"key":"bibr42-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.94B2.27634"},{"key":"bibr43-1938640019892062","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2006.0788"},{"key":"bibr44-1938640019892062","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2014.889979"},{"key":"bibr45-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.2.170009"},{"key":"bibr46-1938640019892062","doi-asserted-by":"publisher","DOI":"10.1177\/1938640015578514"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640019892062","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1938640019892062","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640019892062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:30:53Z","timestamp":1777411853000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1938640019892062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,25]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1177\/1938640019892062"],"URL":"https:\/\/doi.org\/10.1177\/1938640019892062","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,25]]}}}