Fortin Paul T, Guettler Joseph, Manoli Arthur
William Beaumont Hospital, Royal Oak, Ml 48073, USA.
Foot Ankle Int. 2002 Nov;23(11):1031-7. doi: 10.1177/107110070202301111.
Hindfoot malalignment and chronic lateral ankle instability may lead to degenerative ankle arthritis. We retrospectively analyzed 10 patients with 13 cavovarus feet. None of the patients had underlying neurologic disorders. All patients presented with a history consistent with chronic lateral ankle instability, clinically with cavovarus feet, and radiographically with varying degrees of varus talar tilt and ankle arthritis. Ankles with severe degenerative change were fused. The ankles with mild or moderate change underwent calcaneal osteotomy with lateral ligament reconstruction and/or dorsiflexion osteotomy of the first metatarsal. A quantitative radiographic Coleman block test was utilized to aid in the preoperative planning of the calcaneal and metatarsal osteotomies. All patients had correction of preoperative deformity and resolution of pain and instability. Recognition of the association between cavovarus and chronic ankle instability and degenerative ankle arthritis may be important in developing the appropriate treatment strategy in this patient population.
后足排列不齐和慢性外侧踝关节不稳可能导致退行性踝关节炎。我们回顾性分析了10例患者的13只高弓内翻足。所有患者均无潜在神经系统疾病。所有患者均有与慢性外侧踝关节不稳相符的病史，临床检查为高弓内翻足，影像学检查显示距骨内翻倾斜和踝关节炎程度各异。有严重退行性改变的踝关节进行了融合术。有轻度或中度改变的踝关节则接受了跟骨截骨术并重建外侧韧带和/或第一跖骨背屈截骨术。术前使用定量影像学科尔曼阻滞试验辅助跟骨和跖骨截骨术的规划。所有患者术前畸形均得到矫正，疼痛和不稳症状均得以缓解。认识到高弓内翻与慢性踝关节不稳及退行性踝关节炎之间的关联，对于制定该患者群体的合适治疗策略可能很重要。
