Gutiérrez Pedro R, Lara Manuel Herrera
Paediatric Orthopaedic Department, Department of Orthopaedic Surgery and Traumatology of the Hospital General Universitario de Alicante, Spain. Gutierrez
Foot Ankle Int. 2005 Nov;26(11):918-26. doi: 10.1177/107110070502601104.
To determine the clinical and radiographic results of arthroereisis using the Giannini endo-orthotic implant for the treatment of pediatric flatfoot deformity, we retrospectively evaluated 37 patients (65 feet).
Twenty-two boys and 15 girls were followed for an average of 26.5 months. Their overall average age was 9.4 (range 5 to 14) years. Pain, function, participation in sports activity, and the changes in radiographic measurements taken at 3, 6, and 12 months and then at 1-year intervals were evaluated.
Pain or discomfort decreased from 60% (22 patients) preoperatively to 6% (2 patients) postoperatively. The percentage of normal postoperative footprints was 59% (38 feet) with first-degree flatfoot present in 27 feet (41%). Sports activities were taken up by 19 patients (51%) after surgery. An 8-mm endo-orthotic implant was used in 43 (66%) feet and an Achilles tenotomy was done in 38 feet (59%). The radiographic angles with the greatest degree of correction when compared to preoperative angles were the talar-first metatarsal angle (99%) and the calcaneal-pitch (36%). After placement of the endo-orthotic implant, the talar angle influenced the rest of the radiographic measurements. There was no postoperative deterioration in any of the radiographic angles measured during the monitoring period. Complications occurred in 10.7% of the patients, with postoperative pain being the most frequently reported (6% of patients). There was no infection or local reaction to a foreign body. Removal of the endo-orthotic implant was not done on a routine basis.
This operative technique respects the anatomical structure of the foot and produces good clinical and radiographic results.
为了确定使用詹尼尼内置矫形植入物进行关节制动治疗小儿扁平足畸形的临床和影像学结果，我们回顾性评估了37例患者（65只脚）。
对22名男孩和15名女孩进行了平均26.5个月的随访。他们的总体平均年龄为9.4岁（范围5至14岁）。评估了疼痛、功能、参与体育活动情况，以及在3、6和12个月时以及之后每年进行的影像学测量变化。
疼痛或不适从术前的60%（22例患者）降至术后的6%（2例患者）。术后正常脚印的百分比为59%（38只脚），27只脚（41%）存在一度扁平足。19例患者（51%）术后开始进行体育活动。43只脚（66%）使用了8毫米的内置矫形植入物，38只脚（59%）进行了跟腱切断术。与术前角度相比，矫正程度最大的影像学角度是距骨-第一跖骨角（99%）和跟骨倾斜角（36%）。放置内置矫形植入物后，距骨角度影响了其他影像学测量结果。在监测期间测量的任何影像学角度均未出现术后恶化。10.7%的患者出现并发症，最常报告的是术后疼痛（6%的患者）。没有感染或对异物的局部反应。内置矫形植入物未常规取出。
这种手术技术尊重足部的解剖结构，产生了良好的临床和影像学结果。
