Nielsen Matthew D, Dodson Erin E, Shadrick Daniel L, Catanzariti Alan R, Mendicino Robert W, Malay D Scot
Division of Foot and Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, PA 15224, USA.
J Foot Ankle Surg. 2011 May-Jun;50(3):311-4. doi: 10.1053/j.jfas.2011.02.002. Epub 2011 Mar 31.
Nonoperative therapy for adult-acquired flatfoot is a reasonable treatment option that is likely to be beneficial for most patients. In this article, we describe the results of a retrospective cohort study that focused on nonoperative measures, including bracing, physical therapy, and anti-inflammatory medications, used to treat adult-acquired flatfoot in 64 consecutive patients. The results revealed the incidence of successful nonsurgical treatment to be 87.5% (56 of 64 patients), over the 27-month observation period. Overall, 78.12% of the patients with adult-acquired flatfoot were obese (body mass index [BMI] ≥ 30), and 62.5% of the patients who failed nonsurgical therapy were obese; however, logistic regression failed to show that BMI was statistically significantly associated with the outcome of treatment. The use of any form of bracing was statistically significantly associated with successful nonsurgical treatment (fully adjusted OR = 19.8621, 95% CI 1.8774 to 210.134), whereas the presence of a split-tear of the tibialis posterior on magnetic resonance image scans was statistically significantly associated with failed nonsurgical treatment (fully adjusted OR = 0.016, 95% CI 0.0011 to 0.2347). The results of this investigation indicate that a systematic nonsurgical treatment approach to the treatment of the adult-acquired flatfoot deformity can be successful in most cases.
成人获得性平足的非手术治疗是一种合理的治疗选择，对大多数患者可能有益。在本文中，我们描述了一项回顾性队列研究的结果，该研究聚焦于用于连续治疗64例成人获得性平足的非手术措施，包括支具治疗、物理治疗和抗炎药物治疗。结果显示，在27个月的观察期内，非手术治疗成功的发生率为87.5%（64例患者中的56例）。总体而言，78.12%的成人获得性平足患者肥胖（体重指数[BMI]≥30），非手术治疗失败的患者中有62.5%肥胖；然而，逻辑回归分析未能显示BMI与治疗结果存在统计学显著关联。使用任何形式的支具与非手术治疗成功在统计学上显著相关（完全调整后的比值比=19.8621，95%置信区间1.8774至210.134），而磁共振成像扫描显示胫后肌有撕裂与非手术治疗失败在统计学上显著相关（完全调整后的比值比=0.016，95%置信区间0.0011至0.2347）。这项调查结果表明，针对成人获得性平足畸形的系统性非手术治疗方法在大多数情况下可能成功。
