Dunn Sean Patrick, Meyer Justin
Foot and Ankle Clinic of Oakwood, Oakwood, GA 30566, USA.
J Foot Ankle Surg. 2011 Jul-Aug;50(4):402-6. doi: 10.1053/j.jfas.2011.04.004.
The Evans calcaneal osteotomy is an invaluable tool in the correction of pediatric collapsing pes planovalgus. It has traditionally been performed without the use of fixation. Recently, however, fixation of the Evans osteotomy has been proposed to prevent displacement. A retrospective radiographic study was performed of 33 patients (50 feet) to examine the amount of displacement of the anterior process after performing the Evans osteotomy without fixation. The anterior process height was measured digitally from the radiographs on the lateral view preoperatively, at approximately 6 weeks postoperatively, and at the final follow-up visit. The patients were followed up to a mean of 30.57 (range, 6 to 107) weeks postoperatively. The anterior process showed a statistically significant dorsal displacement of 1.21 mm (95% confidence interval 0.29, 2.12, P = .0001) at 6 weeks postoperatively. This had diminished to an insignificant dorsal displacement of 0.57 mm (95% confidence interval -0.21, 1.34, P = .148) at the final follow-up visit. Clinically and statistically significant improvements in the calcaneal inclination and talar declination angles were observed in the early and late postoperative periods. None of the patients experienced a postoperative complication that required a return to the operating room.
埃文斯跟骨截骨术是矫正小儿塌陷性平足外翻的一项宝贵技术。传统上该手术不使用内固定。然而，近来有人提议对埃文斯截骨术进行固定以防止移位。进行了一项回顾性影像学研究，纳入33例患者（50只足），以检查未行固定的埃文斯截骨术后前突的移位量。术前、术后约6周以及末次随访时，在侧位X线片上数字化测量前突高度。患者术后平均随访30.57周（范围6至107周）。术后6周时，前突出现了具有统计学意义的背侧移位1.21 mm（95%置信区间0.29，2.12，P = .0001）。在末次随访时，该移位已减小至无统计学意义的背侧移位0.57 mm（95%置信区间 -0.21，1.34，P = .148）。术后早期和晚期均观察到跟骨倾斜角和距骨倾斜角在临床和统计学上有显著改善。没有患者出现需要返回手术室处理的术后并发症。
