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跟骨围巾截骨术:成人后天性平足畸形的手术矫正及影像学结果

The calcaneal scarf osteotomy: surgical correction of the adult acquired flatfoot deformity and radiographic results.

作者信息

Feuerstein Catherine A, Weil Lowell, Weil Lowell Scott, Klein Erin E, Agerakis Nicholas G, Akram Usman

机构信息

Weil Foot & Ankle Institute, Des Plaines, Illinois.

出版信息

Foot Ankle Spec. 2013 Oct;6(5):367-71. doi: 10.1177/1938640013499627. Epub 2013 Aug 21.

Abstract

PURPOSE

Surgical correction of the adult acquired flatfoot deformity (AAFD) is continually evolving. This technique article presents the technique of the calcaneal scarf osteotomy (CSO) and radiographic evidence supporting the ability of this procedure to correct an AAFD.

METHOD

The technique described here is a single osteotomy that corrects flatfoot deformity in all 3 planes. Retrospectively, medical records were reviewed to identify patients who underwent a CSO for surgical correction of AAFD. Pre- and postoperative radiographs were reviewed.

RESULTS

Thirty patients (32 feet) had an average age of 49.0 ± 17.2 years (range = 35-73 years) with an average of 5.7 ± 2.0 years (range = 1-11 years) of follow-up. Anteroposterior and lateral radiographic parameters were significantly altered with this procedure (P < .001). CSO-induced calcaneal-cuboid joint arthritis did not occur.

DISCUSSION AND CONCLUSIONS

The results of the current study demonstrate that the CSO significantly changes radiographic exam parameters in patients who suffer from AAFD. Therefore, the CSO provides triplanar correction through one osteotomy with early return to weight bearing and lacks the complications such as lateral column pain associated with other calcaneal osteotomies.

LEVELS OF EVIDENCE

Level IV, Retrospective cohort study.

摘要

目的

成人获得性平足畸形(AAFD)的手术矫正方法在不断发展。本文介绍了跟骨围巾截骨术(CSO)技术及支持该手术矫正AAFD能力的影像学证据。

方法

本文所述技术为单一截骨术,可在三个平面矫正平足畸形。回顾性分析病历,以确定接受CSO手术矫正AAFD的患者。回顾术前和术后的X线片。

结果

30例患者(32足),平均年龄49.0±17.2岁(范围35 - 73岁),平均随访5.7±2.0年(范围1 - 11年)。该手术使前后位和侧位影像学参数发生显著改变(P <.001)。未发生CSO引起的跟骰关节关节炎。

讨论与结论

本研究结果表明,CSO能显著改变AAFD患者的影像学检查参数。因此,CSO通过一次截骨提供三平面矫正,可早期负重,且无其他跟骨截骨术相关的并发症,如外侧柱疼痛。

证据级别

IV级,回顾性队列研究。

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