Department of Foot and Ankle Surgery, The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
J Bone Joint Surg Am. 2010 Jan;92(1):81-91. doi: 10.2106/JBJS.H.01057.
Lateral column lengthening, a commonly used adjuvant for the reconstruction of adult flatfoot deformity, can lead to postoperative complaints of lateral plantar pain or discomfort. We hypothesized that patients with such symptoms would have increased lateral plantar pressures when compared with matched controls without these symptoms.
Ten subjects who had undergone lateral column lengthening and were experiencing pain or discomfort in the plantar-lateral aspect of the foot were selected. Controls who had undergone lateral column lengthening but who were not experiencing such symptoms were matched for age, sex, accessory reconstructive procedures, and time from surgery. At the time of the present study, the patients had been followed for at least two years after the reconstruction and had had removal of hardware. Radiographs of each foot were assessed before and after surgery. The patients completed the Short Form-36 (SF-36) and Foot and Ankle Outcome Score surveys, and standing plantar pressure measurements were obtained. Average mean pressure, peak pressure, and maximum force were assessed at twelve anatomic regions and the two groups were compared.
There were no significant preoperative differences between the two groups in terms of radiographic parameters. Patients with pain had significantly lower SF-36 Physical Health Summary scores (p < 0.05), SF-36 Physical Function Subscale scores (p < 0.05), and average Foot and Ankle Outcome Scores (p < 0.05). Patients with pain had significantly higher lateral midfoot average mean pressure (p < 0.05), peak pressure (p < 0.05), and maximum force (p < 0.05). No differences were found in the hindfoot or forefoot regions.
Patients who have undergone lateral column lengthening and who experience lateral plantar pain have increased plantar pressure values in the lateral aspect of the midfoot. The increased pressures in this area cannot be accounted for solely by radiographic or demographic factors.
外侧柱延长术是一种常用于重建成人扁平足畸形的辅助方法，但会导致术后患者出现足底外侧疼痛或不适等症状。我们假设，与没有这些症状的患者相比，出现这些症状的患者的足底外侧压力会增加。
选择了 10 名接受外侧柱延长术且足部足底外侧出现疼痛或不适的患者作为病例组。选择了年龄、性别、辅助重建手术和手术时间相匹配但没有出现这些症状的患者作为对照组。在本研究时，病例组在重建后至少随访了两年，并且已经去除了内固定物。对每只脚的影像学检查进行了术前和术后评估。患者完成了健康调查简表 36 项（Short Form-36，SF-36）和足踝结局评分（Foot and Ankle Outcome Score）调查，并进行了站立位足底压力测量。评估了 12 个解剖区域的平均压力、峰值压力和最大力，并比较了两组之间的差异。
两组患者在术前影像学参数方面没有显著差异。有疼痛的患者 SF-36 健康总体评分（Physical Health Summary score，PCS）较低（p < 0.05），SF-36 躯体功能子量表评分（Physical Function Subscale score，PF）较低（p < 0.05），足踝结局评分（Foot and Ankle Outcome Score，FAOS）较低（p < 0.05）。有疼痛的患者的中足外侧平均压力（average mean pressure，AMP）、峰值压力（peak pressure，PP）和最大力（maximum force，MF）较高（p < 0.05）。在足跟和前足区域未发现差异。
接受外侧柱延长术且出现足底外侧疼痛的患者，其中足外侧的足底压力值增加。该区域的压力增加不能仅用影像学或人口统计学因素来解释。
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