Roche Andrew J, Calder James D F
Department of Trauma and Orthopaedic Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
Foot Ankle Clin. 2012 Jun;17(2):259-70. doi: 10.1016/j.fcl.2012.03.005.
Lateral column lengthening procedures, either an Evans-type procedure or a calcaneocuboid distraction arthrodesis, clearly have a role to play in the management of a pes planovalgus foot deformity, as is evident from clinical outcome studies. Despite an abundance of literature intricately detailing the biomechanical effects of different operative procedures on the hindfoot, there is no clear consensus as to the best procedure or procedures to perform for a flexible pes planovalgus foot deformity. There is, therefore, no single solution to this problem; the surgeon must treat each patient as an individual and choose the procedure that will work best in their hands for any given foot pathology they are presented with. The surgeon must also be aware that to improve the kinematics of a planovalgus foot deformity, one may often have to perform multiple procedures and not a lateral column lengthening in isolation.
外侧柱延长手术，无论是埃文斯（Evans）式手术还是跟骰关节撑开融合术，在扁平足畸形的治疗中显然都能发挥作用，这从临床结果研究中可以明显看出。尽管有大量文献详细阐述了不同手术操作对后足的生物力学影响，但对于治疗柔韧性扁平足畸形的最佳手术方案，尚无明确的共识。因此，这个问题没有单一的解决方案；外科医生必须将每个患者视为个体，并根据所面对的任何特定足部病理情况，选择在其手中效果最佳的手术方案。外科医生还必须意识到，为了改善扁平足畸形的运动学，通常可能需要进行多种手术，而不是孤立地进行外侧柱延长手术。
