Momberger N, Morgan J M, Bachus K N, West J R
University of Utah, Salt Lake City 84112, USA.
Foot Ankle Int. 2000 Sep;21(9):730-5. doi: 10.1177/107110070002100903.
The purpose of this study is twofold: first, to measure the joint contact pressure across the calcaneocuboid joint in a planovalgus deformity and compare the results to pressures measured in a normal foot; and second, to determine the change in pressure across the calcaneocuboid joint after an Evan's-type calcaneal lengthening osteotomy. The effect of this procedure on the calcaneocuboid joint was evaluated using seven cadaver feet to measure peak pressure across the calcaneocuboid joint under a constant load. Each foot was sectioned medially to reproduce a deformity consistent with an adult, acquired flatfoot. Each flatfoot deformity was then corrected using a ten-millimeter lateral column lengthening osteotomy. Joint pressures were measured in the normal foot, the created flatfoot and then in the corrected flatfoot. Peak pressures across the joint increased significantly from baseline in the flatfoot (p <0.05). However, the change in pressure from the flatfoot to the corrected foot was not significant, and in some cases peak pressures in the corrected foot were actually lower than in the flatfoot. These findings indicate that calcaneal lengthening through an Evan's osteotomy does not increase pressure across the calcaneocuboid joint beyond physiologic loads in the flatfoot.
第一，测量扁平外翻畸形中跟骰关节的关节接触压力，并将结果与正常足所测压力进行比较；第二，确定埃文斯式跟骨延长截骨术后跟骰关节压力的变化。使用七具尸体足来评估该手术对跟骰关节的影响，以测量在恒定负荷下跟骰关节的峰值压力。每只足在内侧进行剖切，以重现与成人后天性平足一致的畸形。然后使用十毫米的外侧柱延长截骨术矫正每个扁平足畸形。在正常足、制造出的扁平足以及矫正后的扁平足中测量关节压力。扁平足中关节的峰值压力相较于基线显著增加（p<0.05）。然而，从扁平足到矫正足的压力变化并不显著，在某些情况下，矫正足中的峰值压力实际上低于扁平足。这些发现表明，通过埃文斯截骨术进行跟骨延长不会使跟骰关节的压力增加到超过扁平足生理负荷的程度。
