Lin Jason S, Myerson Mark S
The Institute for Foot and Ankle Reconstruction, Mercy Medical Center, Baltimore, MD, USA.
Instr Course Lect. 2011;60:321-34.
Adult acquired flatfoot deformity encompasses a wide spectrum of clinical conditions. Current management approaches have emerged from a growing understanding of its manifestations, which have been learned from decades of clinical trial and error. Although surgical trends continue to evolve, many basic principles and practices have endured. Adult flatfoot deformity can arise from multiple causes, the most common of which remains posterior tibial tendon rupture with subsequent elongation of secondary supportive structures. Regardless of the cause, the fundamental goals of surgical management include correcting peritalar subluxation, restoring hindfoot-midfoot-forefoot relationships and muscle balance, attaining a plantigrade foot, and preserving motion when possible. Surgical correction may be associated with a variety of potential problems, including errors in decision making, undertreatment, overcorrection, and technical mistakes. These complications can lead to adjacent joint arthritis, recurrent deformity, rigidity, nonunion, and persistent pain.
成人获得性平足畸形涵盖了广泛的临床病症。当前的治疗方法源于对其表现形式的深入了解，这些表现是通过数十年的临床试验和错误积累而来的。尽管手术趋势不断演变，但许多基本原则和做法依然存在。成人平足畸形可由多种原因引起，其中最常见的是胫后肌腱断裂，随后继发支持结构伸长。无论病因如何，手术治疗的基本目标包括纠正距骨周围半脱位、恢复后足-中足-前足关系和肌肉平衡、实现足底着地的足以及尽可能保留运动功能。手术矫正可能会伴有各种潜在问题，包括决策失误、治疗不足、过度矫正和技术失误。这些并发症可导致相邻关节关节炎、复发性畸形、僵硬、不愈合和持续疼痛。
