Foot Ankle Int. 2010 Aug;31(8):695-700. doi: 10.3113/FAI.2010.0695.
Little progress has been made addressing reconstruction of the static medial ligamentous structures of the foot. The purpose of this investigation was to reconstruct a flatfoot deformity with a novel static medial ligamentous complex (MLC) and evaluate its ability to correct talar head subluxation and radiographic deformity in a cadaveric model.
Eight fresh frozen cadaveric specimens underwent cyclic preconditioning and static axial loading. Loading was applied to the intact foot, the severe flatfoot, and the reconstructed MLC foot. Anteroposterior (AP) and lateral radiographs were taken at each stage. The talo-first metatarsal angle, medial cuneiform height, talocalcaneal angle, and the calcaneal pitch angle were measured on the lateral views and the talo-first metatarsal angle was measured on the anteroposterior views.
Compared with the intact foot, the flatfoot showed significant change in the AP talo-first metatarsal angle (p = 0.001), the lateral talo-first metatarsal angle (p = 0.002), the medial cuneiform height (p = 0.007), the talocalcaneal angle (p = 0.03), and the calcaneal pitch angle (p = 0.018). After MLC reconstruction, there was a significant change in the AP talo-first metatarsal angle (p = 0.001), the lateral talo-first metatarsal angle (p = 0.002), and the medial cuneiform height (p = 0.007) and these values were not significantly different than the intact foot. The talocalcaneal angle and the calcaneal pitch angle remained significantly undercorrected after static MLC reconstruction.
Static MLC reconstruction was effective in correcting several key radiographic parameters in a cadaveric flatfoot model.
The surgical technique evaluated here may be useful as a new soft tissue reconstructive procedure for treating adult flatfoot.
在解决足部静态内侧韧带结构重建方面进展甚微。本研究旨在构建一种新的静态内侧韧带复合体（MLC）来重建扁平足畸形，并评估其在尸体模型中纠正距骨头部半脱位和影像学畸形的能力。
8 个新鲜冷冻尸体标本进行了循环预适应和静态轴向加载。在完整足、严重扁平足和重建 MLC 足三个模型上施加加载。在每个阶段都拍摄前后位（AP）和侧位 X 线片。在侧位片上测量距骨第一跖骨角、内侧楔骨高度、距跟骨角和跟骨倾斜角，在前后位片上测量距骨第一跖骨角。
与完整足相比，扁平足的 AP 距骨第一跖骨角（p = 0.001）、侧位距骨第一跖骨角（p = 0.002）、内侧楔骨高度（p = 0.007）、距跟骨角（p = 0.03）和跟骨倾斜角（p = 0.018）均有显著变化。MLC 重建后，AP 距骨第一跖骨角（p = 0.001）、侧位距骨第一跖骨角（p = 0.002）和内侧楔骨高度（p = 0.007）均有显著变化，但与完整足无显著差异。距跟骨角和跟骨倾斜角在静态 MLC 重建后仍明显矫正不足。
静态 MLC 重建可有效矫正尸体扁平足模型中的多个关键影像学参数。
本文评估的手术技术可能有助于作为一种新的软组织重建技术治疗成人扁平足。
