Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
Foot Ankle Int. 2011 Jul;32(7):665-73. doi: 10.3113/FAI.2011.0665.
One of the major concerns with lateral column lengthening (LCL) in symptomatic flatfoot deformity treatment is the risk of postoperative plantar lateral foot discomfort. We evaluated whether this risk can be minimized by using trial metal wedges. Using our study's evaluation tools, the incidence of postoperative plantar lateral foot discomfort before and after using trial metal wedges was determined.
The incidence of planter lateral foot pain after LCL was retrospectively assessed in 122 consecutive patients (132 feet) after they had undergone flatfoot reconstruction with LCL between 2001 and 2007. To determine if the incidence could be reduced, levels of pain or revision were compared before and after the use of trial metal wedges. The ratio of wedge size to preoperative radiographic calcaneal length was also determined.
The overall incidence of plantar lateral discomfort was 11.2%. The incidence of pain or revision was lower after the introduction of trial metal wedges (6.3% compared to 14.7%), but did not reach significance (p = 0.084). There was no significant difference found in the ratio of the size of bone graft wedge to calcaneal length between the two groups (p = 0.805).
The incidence of plantar lateral foot discomfort overall was 11.2% after LCL. We believe this risk may be reduced using trial metal wedges, properly judging eversion stiffness and carefully assessing the position of the foot intraoperatively.
在治疗有症状的平足畸形的外侧柱延长（LCL）中，主要关注的问题之一是术后足底外侧足部不适的风险。我们评估了使用试验金属楔形物是否可以最小化这种风险。使用我们研究的评估工具，确定使用试验金属楔形物前后术后足底外侧足部不适的发生率。
回顾性评估了 2001 年至 2007 年间接受 LCL 平足重建的 122 例连续患者（132 只脚）的 LCL 后足底外侧足部疼痛的发生率。为了确定发生率是否可以降低，比较了使用试验金属楔形物前后疼痛或修订的程度。还确定了楔形物大小与术前 X 线跟骨长度的比值。
足底外侧不适的总发生率为 11.2%。使用试验金属楔形物后疼痛或修订的发生率较低（6.3%比 14.7%），但无统计学意义（p=0.084）。两组之间骨移植楔形物大小与跟骨长度的比值无显著差异（p=0.805）。
LCL 后足底外侧足部不适的总发生率为 11.2%。我们认为，通过正确判断外翻刚度和仔细评估术中足部位置，可以使用试验金属楔形物降低这种风险。
