Pinzur Michael S, Sostak James
Loyola University Medical Center, Maywood, IL 60153, USA.
Am J Orthop (Belle Mead NJ). 2007 Jul;36(7):361-5.
Fifty-one adults (28 men, 23 women) with Charcot arthropathy of the midfoot underwent surgical correction. Mean patient age was 58 years (SD, 9.9 years). All affected feet were nonplantigrade and at high risk for ulcers. Before surgery, mean lateral talar-first metatarsal angle was 27.6 degrees (SD, 12.8 degrees). Corrective osteotomy was performed to achieve plantigrade alignment. At minimum 1-year follow-up, 44 of 51 patients had the desired outcome. Mean lateral talar-first metatarsal angle had decreased to 6.4 degrees (SD, 7.7 degrees). Despite its associated high complication rate, corrective osteotomy can help patients become ulcer- and infection-free and maintain their ability to walk with commercially available therapeutic footwear. A treatment algorithm is presented.
51例患有中足夏科氏关节病的成年人（28名男性，23名女性）接受了手术矫正。患者平均年龄为58岁（标准差9.9岁）。所有患足均非足底负重位且有发生溃疡的高风险。术前，平均距骨外侧-第一跖骨角为27.6度（标准差12.8度）。进行了矫正截骨术以实现足底负重位对线。在至少1年的随访中，51例患者中有44例获得了理想的结果。平均距骨外侧-第一跖骨角已降至6.4度（标准差7.7度）。尽管矫正截骨术有较高的并发症发生率，但它可以帮助患者避免溃疡和感染，并通过使用市售治疗性鞋具维持行走能力。本文提出了一种治疗算法。
