Zaret David I, Myerson Mark S
Institute for Foot and Ankle Reconstruction at Mercy, Mercy Medical Center, 301 St. Paul Place, Baltimore, MD 21202, USA.
Foot Ankle Clin. 2003 Sep;8(3):605-17. doi: 10.1016/s1083-7515(03)00041-x.
Arthroerisis of the subtalar joint can be a valuable tool for the foot and ankle surgeon in treating flexible pes planus deformity in adults, as well as in children. Whether by itself, or in conjunction with other procedures, such as Achilles tendon lengthening (to allow dorsiflexion to at least neutral), midfoot or hindfoot osteotomies (to correct significant bony deformities), and posterior tibial tendon advancements (with associated symptomatic accessory navicular), arthroerisis can be helpful to correct deformity. When compared with procedures that involve osteotomy or arthrodesis, there is less morbidity to the patient who undergoes arthoerisis during surgery as well as postoperatively. There is no risk of nonunion, less immobilization is usually required, and arthroerisis is technically easy to perform. As with all surgical procedures, proper patient selection is extremely important.
距下关节制动术对于足踝外科医生治疗成人及儿童的柔韧性扁平足畸形而言，可能是一项很有价值的手段。无论是单独使用，还是与其他手术联合使用，如跟腱延长术（以使背屈至少达到中立位）、中足或后足截骨术（以矫正明显的骨性畸形）以及胫后肌腱前移术（伴有相关症状性副舟骨），距下关节制动术都有助于矫正畸形。与涉及截骨术或关节融合术的手术相比，接受距下关节制动术的患者在手术期间及术后的发病率更低。不存在骨不连的风险，通常需要的固定较少，并且距下关节制动术在技术上易于实施。与所有外科手术一样，正确选择患者极为重要。
