Laboratoire de Physiologie de l'Exercice, EA 4338, Centre Hospitalier et universitaire de Saint Etienne, Saint Etienne Cedex 2, France.
Arch Orthop Trauma Surg. 2010 May;130(5):599-603. doi: 10.1007/s00402-009-1029-z. Epub 2010 Jan 5.
We report a series of 15 double-hindfoot (subtalar and talonavicular joint) arthrodeses through a single medial approach on 14 patients. Mean age at surgery was 59.3 years. The chosen surgical technique was always identical using a medial approach and performed by a single surgeon. The average follow-up was 20.6 months.
The mean Kitaoka score increased from 44 to 75, axis of the hindfoot decreased from 21 degrees to 11 degrees in valgus, arch foot angle decreased from 142 degrees to 134.4 degrees . Two failures have led to a secondary complementary arthrodesis of the talocrural joint.
Throughout our study, subtalar and talonavicular arthrodesis in the treatment of painful valgus deformities of the hindfoot reveals to be a valuable and safe alternative. The chosen fixation method combined with a good articular surface avivement through medial approach guarantee a long-term fusion. Moreover, resort to a medial approach significantly reduces wound complications.
This medial approach procedure permits the fusion without developing non-union and provides a significant correction of the fixed deformities.
我们报告了 14 例患者通过单一内侧入路进行的 15 例双后足(距下和跗跖关节)融合术。手术时的平均年龄为 59.3 岁。选择的手术技术始终是相同的,使用内侧入路,由一位外科医生完成。平均随访时间为 20.6 个月。
Kitaoka 评分平均从 44 分增加到 75 分,后足轴线从 21 度变为 11 度的外翻,足弓角度从 142 度变为 134.4 度。有 2 例失败导致了踝关节的二次补充融合。
在我们的研究中,距下和跗跖关节融合术治疗后足疼痛性外翻畸形是一种有价值且安全的选择。选择的固定方法结合内侧入路良好的关节面活力保证了长期融合。此外,采用内侧入路显著降低了伤口并发症。
这种内侧入路手术可以在不发生不愈合的情况下进行融合,并提供固定畸形的显著矫正。