{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T14:47:10Z","timestamp":1760453230998,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,12,3]],"date-time":"2023-12-03T00:00:00Z","timestamp":1701561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Foot deformities in children are common, and the majority can be treated conservatively. Nevertheless, there are deformities that require surgical treatment. These include rigid clubfeet, severe forms of pes planovalgus, pes cavus and several more. We retrospectively analysed the pseudarthrosis rate of surgical treatment of foot deformities with transcutaneous K-wire osteosynthesis in neurologically healthy children and adolescents. The aim of the study was to show that the results with K-wires are comparable to those with other osteosynthesis methods in the literature. Methods: A total of 46 paediatric patients aged 6 to 17 years treated between January 2010 and December 2015 met the inclusion criteria. Depending on the diagnosis, different surgical interventions were necessary. In clubfoot and pes planovalgus, representing n = 81, 70% of the whole collective triple arthrodesis with fusion of the talonavicular, calcaneocuboid and subtalar joints or Evans osteotomy was usually performed. Radiographs were taken at least 6 months post-surgery, and bony consolidation of the subtalar, talonavicular (TN), and calcaneocuboidal (CC) joints and the metatarsal I (MT I) osteotomy were assessed. If there was no evidence of fusion at this time, it was considered non-union. Results: In total, 117 arthrodesis procedures with K-wires were performed. Overall, 110 of the arthrodesis (94%) healed, and only 7 joints (6%) showed non-union (subtalar 0%, TN 7.7%, CC 6.5% and MT I 6.7%). All non-unions occurred in subjects with clubfoot deformities. No significant risk factors were observed. Conclusion: This study replicated the good consolidation rates reported in the literature with screws, plates, intramedullary nails or staples in arthrodesis of the adolescent foot in neurologically healthy subjects and confirmed the efficacy of K-wires. The main advantages of transcutaneous K-wire treatment are easy metal removal, lower osteosynthesis material costs and less concomitant damage. Further studies, especially randomised controlled trials, are needed to further investigate this topic.<\/jats:p>","DOI":"10.3390\/jcm12237478","type":"journal-article","created":{"date-parts":[[2023,12,3]],"date-time":"2023-12-03T04:59:16Z","timestamp":1701579556000},"page":"7478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["K-Wire Osteosynthesis for Arthrodesis of the Paediatric Foot Is a Good and Valid Procedure"],"prefix":"10.3390","volume":"12","author":[{"given":"Jannes","family":"Kreher","sequence":"first","affiliation":[{"name":"Orthopedics and Trauma Surgery, BGU Hospital Ludwigshafen, Ludwig Guttmann Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"Putz","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Fackler","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"International Center for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9\u201315, 69115 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-030X","authenticated-orcid":false,"given":"Axel","family":"Horsch","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Geisb\u00fcsch","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Heidelberg University Hospital, Schlierbacher Landstra\u00dfe 200a, 69118 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00264-023-05837-3","article-title":"Flatfoot over the centuries: The background of current conservative and operative treatments","volume":"47","author":"Biz","year":"2023","journal-title":"Int. Orthop."},{"key":"ref_2","unstructured":"Krauspe, R., Weimann-Stahlschmidt, K., and Westhoff, B. (2011). European Instructional Lectures, Springer."},{"key":"ref_3","first-page":"159","article-title":"Das abgeflachte Fu\u00dfl\u00e4ngsgew\u00f6lbe","volume":"28","author":"Hefti","year":"1999","journal-title":"Der Orthop\u00e4de"},{"key":"ref_4","first-page":"469","article-title":"Hypermobility of the first ray","volume":"5","author":"Myerson","year":"2000","journal-title":"Foot Ankle Clin."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ganesan, B., Luximon, A., Al-Jumaily, A., Balasankar, S.K., and Naik, G.R. (2017). Ponseti method in the management of clubfoot under 2 years of age: A systematic review. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178299"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Dreher, T., Hagmann, S., and Wenz, W. (2009). Reconstruction of Multiplanar Deformity of the Hindfoot and Midfoot with Internal Fixation Techniques. Foot Ankle Clin., 14.","DOI":"10.1016\/j.fcl.2009.06.001"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bresnahan, P.J., and Juanto, M.A. (2020). Pediatric Flatfeet\u2014A Disease Entity That Demands Greater Attention and Treatment. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00019"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.cpm.2009.09.001","article-title":"Flexible Pediatric and Adolescent Pes Planovalgus: Conservative and Surgical Treatment Options","volume":"27","author":"Blitz","year":"2010","journal-title":"Clin. Podiatr. Med. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S1067-2516(97)80035-X","article-title":"Our fixation with fixation: Are screws clinically superior to external wires in distal first metatarsal osteotomies?","volume":"36","author":"Armstrong","year":"1997","journal-title":"J. Foot Ankle Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"514","DOI":"10.4055\/cios.2017.9.4.514","article-title":"Biomechanical comparison study of three fixation methods for proximal chevron osteotomy of the first metatarsal in hallux valgus","volume":"9","author":"Kim","year":"2017","journal-title":"CiOS Clin. Orthop. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1097\/00007611-197412000-00009","article-title":"Triple arthrodesis in children: A ten-year review","volume":"67","author":"Seitz","year":"1974","journal-title":"South. Med. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"340","DOI":"10.2106\/00004623-196547020-00011","article-title":"Triple arthrodesis. A study of the factors affecting fusion after three hubdred and one procedures","volume":"47","author":"Wilson","year":"1965","journal-title":"J. Bone Jt. Surgery. Am. Vol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11832-016-0730-z","article-title":"Partial or non-union after triple arthrodesis in children: Does it really matter?","volume":"10","author":"Wicks","year":"2016","journal-title":"J. Child. Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1007\/s00264-021-05172-5","article-title":"Comparison between Malerba osteotomy and combined Evans\/medial displacement calcaneal osteotomies for the management of flexible pes planus in young adults: A prospective randomised control trial, three years follow-up","volume":"45","author":"Nagy","year":"2021","journal-title":"Int. Orthop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1302\/1863-2548.14.200073","article-title":"Medium-term results of calcaneus lengthening in idiopathic symptomatic flat foot in children and adolescents","volume":"14","author":"Nejib","year":"2020","journal-title":"J. Child. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/S0030-5898(20)32237-9","article-title":"A long term study of triple arthrodesis in children","volume":"7","author":"Adelaar","year":"1976","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/107110078700700601","article-title":"Triple Arthrodesis in Young Children: A Salvage Procedure After Failed Releases in Severely Affected Feet","volume":"7","author":"Galindo","year":"1987","journal-title":"Foot Ankle Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1007\/s00064-006-1170-6","article-title":"Modified evans osteotomy for the operative treatment of acquired pes planovalgus","volume":"18","author":"Zwipp","year":"2006","journal-title":"Oper. Orthop. Und Traumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/bjs.1800155804","article-title":"New operation on drop-foot","volume":"15","author":"Lambrinudi","year":"1927","journal-title":"Br. J. Surg."},{"key":"ref_20","unstructured":"(2009). Complete Tendon Transfer and Inverse Lambrinudi Arthrodesis: Preliminary Results of a New Technique for the Treatment of Paralytic Pes Calcaneus. Fu\u00df Sprunggelenk, 7, 683\u2013689."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"927","DOI":"10.2106\/00004623-195234040-00020","article-title":"An extra-articular arthrodesis of the subastragalar joint for correction of paralytic flat feet in children","volume":"34","author":"Grice","year":"1952","journal-title":"J. Bone Jt. Surg. Am. Vol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1001\/archsurg.1921.01110050143007","article-title":"The treatment of pes cavus (Hollow claw foot)","volume":"2","author":"Steindler","year":"1921","journal-title":"Arch. Surg."},{"key":"ref_23","first-page":"3","article-title":"The classic. The treatment of claw-foot. By Wallace, H. Cole. 1940","volume":"181","author":"Cole","year":"1983","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1053\/j.jfas.2020.10.016","article-title":"Evans Calcaneal Osteotomy: Assessment of Multiplanar Correction","volume":"61","author":"Lamm","year":"2022","journal-title":"J. Foot Ankle Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/BPB.0000000000000796","article-title":"Calcaneocuboid distraction arthrodesis for children with symptomatic pes planovalgus: Does fixation improve outcomes?","volume":"30","author":"Hyer","year":"2021","journal-title":"J. Pediatr. Orthop. Part B"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1007\/s00264-022-05455-5","article-title":"Grice extra-articular subtalar fusion for spastic pes planovalgus","volume":"46","author":"Osateerakun","year":"2022","journal-title":"Int. Orthop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1302\/0301-620X.57B3.270","article-title":"Calcaneo valgus deformity","volume":"57","author":"Evans","year":"1975","journal-title":"J. Bone Jt. Surg. Ser. B"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hagmann, S., Dreher, T., and Wenz, W. (2009). Skewfoot. Foot Ankle Clin., 14.","DOI":"10.1016\/j.fcl.2009.06.003"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2309499019826492","DOI":"10.1177\/2309499019826492","article-title":"Long-term outcome after Lambrinudi arthrodesis: How they\u2019re doing after three decades","volume":"27","author":"So","year":"2019","journal-title":"J. Orthop. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s00064-011-0027-9","article-title":"Modified Lambrinudi arthrodesis with additional posterior tibial tendon transfer in adult drop foot","volume":"23","author":"Elsner","year":"2011","journal-title":"Oper. Orthop. Traumatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.fcl.2018.01.001","article-title":"Introduction: Why Are There so Many Different Surgeries for Hallux Valgus?","volume":"23","author":"Smyth","year":"2018","journal-title":"Foot Ankle Clin."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.fcl.2010.11.002","article-title":"The Isolated Talonavicular Arthrodesis","volume":"16","author":"Crevoisier","year":"2011","journal-title":"Foot Ankle Clin."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s11832-009-0168-7","article-title":"Talonavicular joint arthrodesis for the treatment of pes planus valgus in older children and adolescents with cerebral palsy","volume":"3","author":"Turriago","year":"2009","journal-title":"J. Child. Orthop."},{"key":"ref_34","first-page":"101966","article-title":"What is the best fixation technique for isolated talonavicular arthrodesis?","volume":"54","author":"Arumugam","year":"2023","journal-title":"\u2014A systematic review. Foot"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1177\/1071100714539658","article-title":"Single-Incision Lateral Approach for Triple Arthrodesis","volume":"35","author":"Moore","year":"2014","journal-title":"Foot Ankle Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.cpm.2011.09.002","article-title":"Complications of Arthrodesis and Nonunion","volume":"29","author":"Martone","year":"2012","journal-title":"Clin. Podiatr. Med. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7478\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:36:50Z","timestamp":1760132210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,3]]},"references-count":36,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jcm12237478"],"URL":"https:\/\/doi.org\/10.3390\/jcm12237478","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,12,3]]}}}