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跗骨联合切除术后的足底接触应力与步态分析

Plantar contact stress and gait analysis after resection of tarsal coalition.

作者信息

Skwara Adrian, Zounta Vassiliki, Tibesku Carsten O, Fuchs-Winkelmann Susanne, Rosenbaum Dieter

机构信息

Department of Orthopaedics and Rheumatology, University Hospital Marburg, Germany.

出版信息

Acta Orthop Belg. 2009 Oct;75(5):654-60.

Abstract

The purpose of this study was to assess the foot loading characteristics and foot function of patients after operative correction of a tarsal coalition. Ten patients who had undergone operative treatment of a tarsal coalition were included in this study. One foot was affected in five patients and both feet in the other five. A calcaneonavicular coalition was present in 12 feet and a talocalcaneal coalition in three feet. Mean follow-up was 11.3 years. Clinical evaluation was based on a standardized questionnaire, a visual analogue scale for pain (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) Score and radiographic evaluation of the last radiographs. An objective analysis of foot loading characteristics was carried out with instrumented gait analysis and pedobarography. The clinical results were overall fair for pain, range of motion and walking distance. The AOFAS also showed fair results (mean: 78.1) at follow-up. Gait analysis revealed alterations in kinematic and kinetic parameters for the operated foot. Pedobarographic analysis showed altered loadings for heel and forefoot. In this study, operative treatment of tarsal coalition achieved fair clinical and radiographic results and did not restore physiologic gait and foot loading.

摘要

本研究的目的是评估跗骨联合手术矫正后患者的足部负荷特征和足部功能。本研究纳入了10例接受过跗骨联合手术治疗的患者。5例患者单足受累,另外5例患者双足受累。12足存在跟舟联合,3足存在距跟联合。平均随访时间为11.3年。临床评估基于标准化问卷、疼痛视觉模拟量表(VAS)、美国矫形足踝协会(AOFAS)评分以及最后一次X线片的影像学评估。采用仪器化步态分析和足底压力测量法对足部负荷特征进行客观分析。疼痛、活动范围和步行距离的临床结果总体一般。随访时AOFAS评分结果也一般(平均:78.1)。步态分析显示手术侧足部的运动学和动力学参数发生改变。足底压力测量分析显示足跟和前足的负荷改变。在本研究中,跗骨联合的手术治疗取得了一般的临床和影像学结果,并未恢复生理步态和足部负荷。

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