Hospital For Special Surgery, New York City, NY 10021, USA.
Foot Ankle Int. 2011 Mar;32(3):225-32. doi: 10.3113/FAI.2011.0225.
The surgical indications, timing, and procedure for flexible flatfoot reconstruction in young patients remains controversial. This retrospective study reports the clinical results of reconstruction of flexible, idiopathic, symptomatic flatfoot in adolescent and young adults indicated for surgery by persistent pain and functional limitations. The hypothesis was that the results of these procedures allow patients to return to sports activities with minimal discomfort or pain.
Sixteen consecutive idiopathic flatfeet in ten patients with a mean age of 15.6 years at the time of surgery (range, 10 to 22) were assessed at a final followup visit at average of 5.2 (range, 2 to 10) years. Reconstruction included combined medializing calcaneal osteotomy and lateral column lengthening in all 16 patients. Flexor digitorum longus transfer (nine), medial column stabilization (eight), and gastroncnemius recession (eight) were carried out as needed. The AOFAS, SF-36, and FAOS questionnaires were completed. Sports activity and patient satisfaction were also assessed. Standard preoperative and postoperative radiographic parameters were measured.
The mean AOFAS score increased on average from 49.1 to 93.4. Only one patient reported a postoperative restriction in sports. The satisfaction level was excellent in 15 feet and good in one foot. Significant improvement in radiographic parameters was noted for the AP talonavicular coverage angle (p < 0.001) and lateral talar-first metatarsal angle (p < 0.001).
Flexible flatfoot reconstruction in a cohort of symptomatic adolescent and young adult patients achieved a reduction of pain and improved functional outcome including the ability to participate in sporting activities.
对于年轻患者的柔性平足重建的手术适应证、时机和手术方法仍存在争议。本回顾性研究报告了手术适应证为持续性疼痛和功能受限的青少年和年轻成人特发性、症状性柔性平足患者的重建结果。假设是这些手术的结果可以使患者在最小的不适或疼痛下恢复运动活动。
在最终随访时，对 10 名患者中的 16 例特发性扁平足（平均年龄 15.6 岁，范围为 10 至 22 岁）进行评估，平均随访时间为 5.2 年（范围为 2 至 10 年）。所有 16 例患者均行联合跟骨内侧骨切开术和外侧柱延长术重建。根据需要进行了趾长屈肌转移术（9 例）、内侧柱稳定术（8 例）和腓肠肌切除术（8 例）。完成了 AOFAS、SF-36 和 FAOS 问卷。还评估了运动活动和患者满意度。测量了标准的术前和术后影像学参数。
平均 AOFAS 评分从 49.1 平均提高到 93.4。只有 1 例患者报告术后运动受限。15 只脚的满意度为优秀，1 只脚为良好。距骨跟骨前足覆盖角（AP）（p < 0.001）和外距骨第一跖骨角（lateral talar-first metatarsal angle）（p < 0.001）的影像学参数显著改善。
对一组有症状的青少年和年轻成人患者进行的柔性平足重建，减轻了疼痛，并改善了功能结果，包括参与运动活动的能力。
