Orthopaedic Associates of Kalamazoo, 3810 Centre Avenue, Portage, MI 49024, USA.
Foot Ankle Int. 2010 Dec;31(12):1057-63. doi: 10.3113/FAI.2010.1057.
Subtle cavovarus foot is a condition that can lead to significant foot pain and disability. We review the results of our treatment algorithm at medium-term followup.
Thirty-five consecutive patients with lateral based symptoms due to an underlying congenital subtle cavovarus foot type were surgically corrected. Various procedures were utilized, including some combination of the following: lateral displacement calcaneus osteotomy, peroneus longus to brevis transfer, dorsiflexion first metatarsal osteotomy, and Achilles tendon lengthening. Twenty-three patients, with 29 feet, returned for followup examination. The mean patient age at the time of surgery was 43.4 years, and the mean followup to date was 4.4 years.
The mean AOFAS ankle hindfoot score preoperatively was 45, and postoperatively was 90. Radiographically, the medial cuneiform to floor height changed from 3.5 cm preoperatively to 3.0 cm postoperatively. The talo-first metatarsal angle improved 7.5 degrees postoperatively. There were no nonunions. No patients to date have gone on to fusions or revisions. Ten feet (34%) required hardware removal. All patients had resolution of their symptoms following hardware removal.
The surgical management for the subtle cavovarus foot based on the proposed treatment algorithm provided symptomatic relief, longstanding correction, and high patient satisfaction.
隐匿性马蹄内翻足是一种可能导致严重足部疼痛和残疾的病症。我们回顾了我们的治疗方案在中期随访时的结果。
35 例因隐匿性先天性马蹄内翻足引起外侧基底症状的连续患者接受了手术矫正。采用了各种手术方法，包括以下一些方法的组合：跟骨外侧移位截骨术、腓骨长短肌转移术、跖骨背屈第一截骨术和跟腱延长术。23 例患者（29 足）返回接受随访检查。手术时患者的平均年龄为 43.4 岁，截至目前的平均随访时间为 4.4 年。
术前 AOFAS 踝关节后足评分平均为 45 分，术后为 90 分。影像学上，内侧楔骨至地面的高度从术前的 3.5 厘米变为术后的 3.0 厘米。距骨第一跖骨角术后改善 7.5 度。无骨不连。迄今为止，没有患者需要进行融合或翻修。10 只脚（34%）需要取出内固定物。所有患者在内固定物取出后症状均得到缓解。
基于提出的治疗方案的隐匿性马蹄内翻足的手术治疗提供了症状缓解、长期矫正和患者满意度高。
