Shriners Hospital for Children, 950 West Faris Road, Greenville, South Carolina 29605, USA.
Bone Joint J. 2013 May;95-B(5):706-13. doi: 10.1302/0301-620X.95B5.30594.
At our institution surgical correction of symptomatic flat foot deformities in children has been guided by a paradigm in which radiographs and pedobarography are used in the assessment of outcome following treatment. Retrospective review of children with symptomatic flat feet who had undergone surgical correction was performed to assess the outcome and establish the relationship between the static alignment and the dynamic loading of the foot. A total of 17 children (21 feet) were assessed before and after correction of soft-tissue contractures and lateral column lengthening, using standardised radiological and pedobarographic techniques for which normative data were available. We found significantly improved static segmental alignment of the foot, significantly improved mediolateral dimension foot loading, and worsened fore-aft foot loading, following surgical treatment. Only four significant associations were found between radiological measures of static segmental alignment and dynamic loading of the foot. Weakness of the plantar flexors of the ankle was a common post-operative finding. Surgeons should be judicious in the magnitude of lengthening of the plantar flexors that is undertaken and use techniques that minimise subsequent weakening of this muscle group.
在我们的机构中，手术矫正儿童有症状的平足畸形一直遵循一种模式，即在治疗后使用影像学和足底压力计来评估结果。对接受手术矫正的有症状平足儿童进行回顾性研究，以评估结果并确定静态对线与足部动态负荷之间的关系。共评估了 17 名儿童（21 只脚），他们在软组织挛缩和外侧柱延长矫正前后使用了标准化的影像学和足底压力计技术，这些技术有可用的正常值数据。我们发现，手术治疗后，足部的静态节段对线明显改善，足的内外侧负重明显改善，前后负重恶化。在影像学静态节段对线和足部动态负荷之间只发现了 4 个有显著意义的关联。踝关节跖屈肌无力是一种常见的术后发现。外科医生应谨慎对待跖屈肌延长的程度，并使用可最大限度减少该肌肉群随后减弱的技术。
