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Flatfoot surgery animation
Orthopaedic surgeons performing subtalar implant procedure at Dworska Hospital (Poland):
☑ Grzegorz Jarosławski MD
☑ Henryk Liszka MD PhD
☑ Konrad Kwolek MD
☑ Szymon Oleksik MD (children)

The arthroereisis (subtalar implant insertion) is performed in the case of pain in the flexible valgus flatfoot, when the deformation has not yet become fixed, i.e. when the foot regains its correct shape in unloaded conditions. The subtalar implant is commonly used in children and young adults.

It is a minimally invasive method, requiring a small skin incision (up to 1.5 cm) on the anterolateral side of the foot. The incision provides access to the sinus tarsi, i.e. the cylindrical canal between the talus and calcaneus. The orthopaedist may increase the space of the sinus tarsi by manually reducing the eversion of the heel. Our orthopaedic surgeons release the interosseous ligament to allow the implant to be placed in the sinus tarsi.

The role of the subtalar implant is to limit the excessive movement between the talus and the calcaneus. while maintaining mobility in the subtalar joint.
The appropriate profile of the implant enables optimal fitting into the sinus tarsi. Our orthopedists use only proven models of subtalar implants.

Before placing the implant in the sinus tarsi, it is necessary to select its appropriate size using a set of dedicated trial sizers. First, a directional wire is inserted through the entire length of the sinus tarsi. A trial sizer is inserted into the sinus tarsi, which allows the surgeon to assess the degree of hindfoot correction. Ultimately, we strive to obtain physiological 5 degrees of hindfoot valgus under load conditions. If there is still excessive calcaneus eversion, the trial sizer's diameter is increased. In the next step, the orthopaedist prepares for the placement of the subtalar implant into the sinus tarsi.

The subtalar implant of the appropriate size is placed on the tip of a compatible screwdriver and then inserted along the guide wire precisely into the sinus tarsi.
The position of the implant is controlled on fluoroscopic images, then the screwdriver and guide wire are removed from the foot.

Thanks to this, flatfoot correction is achieved without the need to cut the bone. For more severe deformities, arthroereisis and osteotomy may be performed together.

If you have any questions regarding flatfoot surgery, do not hesitate to contact us:
[email protected]
+48 12 362 72 60