Turriago Camilo Andrés, Arbeláez Myriam Fernanda, Becerra Luis Carlos
Gait Analysis Laboratory, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia,
J Child Orthop. 2009 Jun;3(3):179-83. doi: 10.1007/s11832-009-0168-7. Epub 2009 Mar 24.
The purpose of this report is to review our experience with talonavicular joint arthrodesis for the treatment of severe valgus foot deformities in older children and adolescents with cerebral palsy (CP).
The clinical, radiographic, and gait parameters results after talonavicular joint arthrodesis were retrospectively reviewed in 32 patients (59 feet) with valgus deformities of the foot. The surgery was performed as part of multiple simultaneous surgeries for the treatment of gait disorders. The mean age of the patients was 13.9 years (range 9-20 years) and the mean follow-up was 40 months (range 18.3-66.7 months).
The clinical and radiographic measurements improved significantly (P = 0.000). There were no significant changes in gait parameters. Symptoms were relieved in most patients with symptomatic preoperative feet. The most frequent complication was pseudoarthrosis, which occurred in seven feet. We found a high rate of satisfaction of patients (or parents) and most of them recommended the procedure to other patients with the same condition.
Talonavicular joint arthrodesis is a reliable technique that provides both functionally and cosmetically good results with a low rate of complications in the treatment of severe pes planus valgus in older children and adolescents with CP. Careful examination should rule out concomitant ankle valgus deformities. A stable fixation of the arthrodesis is recommended.
本报告旨在回顾我们采用距舟关节融合术治疗大龄儿童和青少年脑瘫（CP）患者严重外翻足畸形的经验。
回顾性分析32例（59足）足部外翻畸形患者距舟关节融合术后的临床、影像学和步态参数结果。该手术作为治疗步态障碍的多台同期手术的一部分进行。患者平均年龄13.9岁（9 - 20岁），平均随访40个月（18.3 - 66.7个月）。
临床和影像学测量结果显著改善（P = 0.000）。步态参数无显著变化。大多数术前有症状的足部患者症状得到缓解。最常见的并发症是假关节形成，发生在7只足。我们发现患者（或家长）满意度很高，他们中的大多数向其他患有相同疾病的患者推荐了该手术。
距舟关节融合术是一种可靠的技术，在治疗大龄儿童和青少年CP患者严重扁平外翻足时，能在功能和美观方面取得良好效果，并发症发生率低。应仔细检查以排除合并的踝关节外翻畸形。建议对关节融合进行稳定固定。
