In 1991, Viladot(1) described an implant for the treatment of painless flat
feet in children. This was inserted through a double approach to allow the
talus to function while limiting its ability to slide off the calcaneus. Th
e wineglass shaped prosthesis was inserted into the sinus tarsi with a tibi
alis posterior advancement and soft tissue correction to allow the foot to
adopt a neutral position. This is in keeping with other procedures describe
d for the correction of flatfoot, Viladot reported excellent results in 234
feet operated on in such a manner using clinical, radiological and photopo
dographic parameters. In Sheffield, over three years, 22 implants were inse
rted for similar painless flatfeet in children. The results were assessed u
sing clinical, radiological and pedobarographic parameters.
Viladot was able to demonstrate an improvement in all cases, clinically, ra
diologically and photopodographically with little or no discomfort and a re
turn to preoperative levels of activity including sport, We found that in a
ll cases, postoperative pain was a major feature which limited activity in
all but 2 feet and which reduced the ability to take part in sport and othe
r preoperative pastimes, Unlike Viladot, we were unable to demonstrate cons
istent improvements radiologically, Pedobarographically, the loading of the
first metatarsal head remained unchanged and the centre of pressure was co
rrected in only 14%.